Product complaints and adverse event reporting

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Report veterinarian’s details

Name

Surname

Email Address

Direct contact number

Veterinarian registration number

Practice name

Practice number

Country

Date

Complaint details

Date of event

Product name

Batch number

Expiry date

Vial serial number

Complaint relates to:

Physical or quality aspect of the product e.g. appearance/packaging Product performance or efficacy Adverse event Other

Photos (optional – up to 3)

Details/description of complaint:

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