HOME MEDICAL REQUESTS MEDICAL INFORMATION REQUEST Vifor Pharma is dedicated to providing support for medical enquiries, collecting information about adverse events and handling any queries or concerns about any of our products. Data privacy In order to respond to your enquiry it is necessary to collect some personal information such as your name and contact details. If you have queries concerning personal data or data privacy, please see our data privacy policy. Quick links Unsolicited medical information request Adverse event reporting Product quality complaint Unsolicited medical information request Please use the form below to submit your medical information query. Personal details To help us process your request quickly and effectively, fill the necessary sections below with as much relevant information as possible. Title* Dr Prof Mr Mrs Ms Speciality MD PhD Pharmacist Nurse Other Country* United Kingdom Germany France Spain Italy Switzerland Other Information requested CAPTCHA Math question 1 + 0 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. Vifor Pharma is dedicated to providing support for medical enquiries, collecting information about adverse events and handling any queries or concerns about any of our products. Data privacy In order to respond to your enquiry it is necessary to collect some personal information such as your name and contact details. If you have queries concerning personal data or data privacy, please see our data privacy policy. Quick links Unsolicited medical information request Adverse event reporting Product quality complaint *Mandatory field Data privacy The personal data provided on this form will be stored and used by Vifor Pharma Management Ltd., Flughofstrasse 61, 8152 Glattbrugg, Switzerland and/or its affiliates (“Vifor Pharma”) and their service providers and collaboration partners to process the unsolicited request for medical information and respond to it. After responding to the request, they could use the content of the unsolicited request and the response to it for medical information purposes on an anonymized basis. If the enquiry contains safety information, Vifor Pharma is required by law to forward it to its drug safety department for processing and reporting to health authorities. That department will receive the reporter details to document the source and for follow-up purposes. If you have queries concerning personal data or data privacy, please see our data privacy policy. Authorisation I hereby certify that this is an unsolicited request, initiated by myself and completely independent of Vifor Pharma Group, and that I am a healthcare professional licensed to prescribe, purchase, supply, recommend or administer medicinal products.