Gaelic Laboratories

Medical Information Contact Details

To report any adverse reaction and / or for medical information queries, please contact us via the details below

Medical information/Queries and Reporting Side Effects form

"*" indicates required fields

Name*

Email*

Address*

Your Contact Number*

Name of Product you want to enquire / report*

Strength*

Batch Number*

PL/ PLGB / PA or EU Number*

Expiry Date*

Inquiry Details*

If you experience a side effect that causes you concern, you should seek medical advice from your GP/Pharmacist immediately and please fill out below details.

Adverse event*

Provide details of each symptom

Please Provide Further Information*

other medications prescribed / taken. If pregnancy or breastfeeding, of paediatric / off label use, medication error etc

GP / Pharmacist Details*

Please provide GP / Pharmacist's Name, Address & Telephone Number

Phone

This field is for validation purposes and should be left unchanged.

Gaelic Laboratories Pharmacovigilance Privacy Policy

The information you provide in this form will be recorded by Gaelic Laboratories as part of its legal obligations related to our products and will be protected and handled confidentially and in line with applicable data protection laws and Gaelic Laboratories ’s Privacy Policy.

This information may be shared with other certain health authorities to be evaluated and collated with other events (including quality) recorded about that product or active ingredient, in order to assess the benefit – risk balance of the medicines you have used and if needed to update the product information and for the purposes of attending to your request.

If you do not agree to these uses of your information and wish to object to these processing or wish to access, rectify or delete your personal information please inform us via pv-med.info@gaeliclabs.com.

If you are not the subject of this report, please ensure that individual who is the subject of the report is aware of this submission, including the possible transmission of his/her personal information.