Initials means the first letters of the patients' first name(s) and last name(s).
Please do NOT provide the full name (neither first nor last name) of the patient
All the information and personal data you will hereby share with Tillotts Pharma will be protected and kept confidential in line with internal procedures and local regulations. Your information and personal data will be used for the purpose of drug safety surveillance and to enable us to deal with your enquiry appropriately and it may be shared with such other parties with whom Tillotts Pharma shares responsibility for pharmacovigilance (study of drug-related safety information) for Tillotts Pharma’s products in your country of residence, and/or with health authorities. In this context, your personal data may be transferred within your country of residence, the European Economic Area, and/or a country that the European Commission has decided provides adequate protection for personal data. For more information about how we collect and use your personal data, and your rights with respect to your personal data, please see our privacy notice which is available on our website at https://www.tillotts.com/privacy-policy/