HOME MEDICAL REQUESTS PRODUCT QUALITY COMPLAINT REPORT Current Direct reporter Initial reporter Product information Defect details Additional information Vifor Pharma takes the quality of our products very seriously. Help us to improve the quality of our products. If you have any complaints, please fill out this form with as much relevant information as possible and we'll get back to you as soon as we can. 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. Direct reporter (your details) Personal information Contact information Address Country* United Kingdom Germany France Spain Italy Switzerland Other *Mandatory field Initial reporter Who is reporting? Are direct reporter and initial reporter the same person?* Yes No Customer type Customer type* Pharmacy Healthcare professional Patient Wholesaler Other Personal information Contact information Address Country* United Kingdom Germany France Spain Italy Other *Mandatory field Product information Product details Product type* Finished product API Product name* Aero-OM Aero-OM Forte Avacopan Broncho-Vaxom Dicynone Disflat Dobeven Doxi-OM Doxiproct Doxiproct Plus Doxium Doxivenil Eflevar Feranin Ferinject Ferrum Hausmann Ferrum Hausmann Fol Idafer Injectafer Iroprem Maltofer Maltofer Fol Mircera Noripurum Osvaren Paricalcitol Permeabin Phosphosorb Rayaldee Renegy Simeticone Sorbisterit Tavneos Uro-Vaxom Velphoro Veltassa Venofer Venoferrum Please choose presentation Write pharmaceutical form Presentation* 15ml 60ml 2 tabs 30 tabs 250 tabs Presentation* 2 tabs 20 tabs Presentation* 2 5 10 30 50 Granules Presentation* Capsules Tablets Presentation* 30 50 100 30ml 150ml 200ml 10*5ml 20*5ml bulk API Presentation* 1*2ml 5*2ml 1*10ml 5*10ml 1*20ml bulk API Presentation* 30 50 100 30ml 150ml 200ml 10*5ml 20*5ml bulk API Presentation* 30 50 100 bulk API Presentation* 5*5ml bulk API Presentation* 1*2ml 5*2ml 1*10ml 5*10ml 1*20ml bulk API Presentation* 1*2ml 5*2ml 1*10ml 5*10ml 1*20ml bulk API Presentation* 30 50 100 30ml 150ml 200ml 10*5ml 20*5ml bulk API Presentation* 30 50 100 bulk API Presentation* 30mcg 50mcg 75mcg 100mcg 150mcg 200mcg Presentation* 5*5ml bulk API Presentation* 30*30mcg 90*30mcg Presentation* 1*2ml 5*2ml 1*10ml 5*10ml 1*20ml bulk API Presentation* 10mg Presentation* 2 5 10 30 50 Presentation* 30 90 Granules - Select - 8.4g 16.8g 25.2g Presentation* 5*5ml bulk API Presentation* 5*5ml bulk API *Mandatory field Defect details Defect information Country of occurrence* United Kingdom Germany France Spain Italy Other *Mandatory field Additional information Adverse event details An adverse event?* Yes No Drug administered?* Yes No Unknown Defective sample available?* Yes No Unknown Do you have pictures of the defect? Upload image One file only.256 MB limit.Allowed types: gif, jpg, jpeg, png. Additional information Initial classification* Minor Major Critical Response requested by customer ? Yes No CAPTCHA Math question 3 + 14 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. *Mandatory field