NOTIFICATION OF ADVERSE REACTIONS

 

By email: polatom@sciencepharma.pl
by phone: +48 604 446 658
or with the form: 

    Age of patient:*:

    Sex of the patient:*:
    femalemale

    Your Name*:

    Address for correspondence:

    Phone:

    Email*:

    Medication*:

    Description of adverse event: *

    Comments: