Adverse Event or Product Complaint Form

Date
Name
Address
Telephone
Email Address or Fax Number:
Details or Adverse Event / Product Complaint
Comments:

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Torrent Pharma (UK) Ltd

Aptil Pharma Ltd

Unit 4, Charlwood Court, County Oak Way, Crawley, West Sussex. RH11 7XA. United Kingdom

Telephone: +44 (0) 1293 574180 | Fax: +44 (0) 1293 533003 | Email: drugsafety@torrentpharma.co.uk

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