Instruction for Filling the Form

The form for reporting adverse drug reactions / side effects is available in two basic versions: patient report and healthcare professional (physician, pharmacist…) report. Version for physicians and pharmacists is an enhanced version of the patient form. You can switch the version even during filling in the form at the menu on the left side of the screen.

Fields marked with an asterisk (*) are required. If they are not filled in properly, note occurs on the screen and red exclamation mark (!) occurs before the erroneous Data box.

Data box indicates the selection of pre-set options.

To submit the completed form please write letters from the picture and press SEND.

You will be informed about successful form submission directly on the screen. If you included your email address, the system will automatically deliver you information on the accepting of your report.