##  [Medical Information](https://www.novartis.com/be-fr/medical-information "Medical Information") 

  



Please enter the following form to submit your medical question on one of our Novartis products.

If wish to make a product complaint, please do not use this form, instead, send an email to [countryquality.complaints@novartis.com](mailto:%C2%A0countryquality.complaints@novartis.com).



 Name

 

 E-mail address

 

  I am a...    Physician  

   Pharmacist  

   Nurse  

   Patient/Caregiver  

   Other...  



 

 Question 

 

  Does your question include an adverse event?    No  

   Yes  



 

 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 organize 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.com/be-nl/novartis-privacyverklaring-voor-websites](https://www.novartis.com/be-fr/notice-dinformation-sur-la-protection-des-donnees-caractere-personnel-site-internet "Notice d’information sur la protection des données à caractère personnel – Site Internet")

 

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- [Imprimer](https://www.novartis.com/be-fr/node/70131/printable/print)
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