Information Request Form
If you wish to report an Adverse Event, please email email@example.com or call +44(0) 333 200 4143.
The data provided above will be processed by Merz in order to fulfil your request and is restricted to only those individuals who need access to it. Your data will be stored indefinitely (and restricted to only those individuals who need access to it) as there is a business need to keep a history of all medical information requests. If you have any questions regarding the processing and storing of your data, or the exercise of your rights in relation to your data, pleasedo not hesitate to contact Merz Therapeutics GmbH on firstname.lastname@example.org
M-MT-UKI-0139 Date of Preparation April 2022