About this service

Enquiries Form

Healthcare professionals may use this form to submit enquiries to the East Anglia Medicines Information Service.

 

East Anglia MIS enquiries

Healthcare professionals may use this form to submit enquiries to the East Anglia Medicines Information Service.
  • Section 1

    Contact details
    If 'Yes' please proceed to continue to Section 2. If 'No' please proceed to Section 3.
  • Section 2

    Patient details
  • Date Format: DD slash MM slash YYYY
  • Section 3

    Question details
  • Date Format: DD slash MM slash YYYY
    Please note you may be contacted if we cannot meet this deadline. Please give a specific date - do not use ASAP.
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