Medical Information Form Please enter the following form to submit your medical question on one of our Novartis products. If you wish to make a product complaint, please do not use this form, but send an email to [email protected]. Thank you! Name * Surname * E-mail address * I am a... * Physician Pharmacist Nurse Patient/Caregiver Other Question * Does your question include an adverse event? * YES NO Phone Number Disease Area * Oncology Hematology Dermatology Ophthalmology Cardiology Respiratory Neuroscience Rheumatology Other Indication User Data Agreement * I agree to the statement below The Novartis Pharma NV, with headquarters at Medialaan 40, 1800 Vilvoorde ("Novartis") processes your personal data as a controller, in order to (i) communicate with you about the performance of our contracts and/or the management of the relationship with you/your employer, (ii) send commercial and other information in relation to our products and services, (iii) invite you to scientific and other events that we organise or to which we participate, (iv) preserve the company's economic interests and (v) respect our legal obligations. Novartis will also process the content of the exchanges with you following such communications. All the information regarding the processing of your personal data by Novartis, our obligations and your rights in this respect (including your right of access to, rectification or erasure of your personal data as well as your right to request, as the case may be, the portability or the restriction of your personal data and your right to object to the processing thereof) is available on our website at the following address: https://www.novartis.be/nl/novartis-privacyverklaring-voor-websites FA-NA CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
