Mecapharma

Medical Information Form

Country

Product

Urgent

Requester's Information

Name

Qualification (Physician, nurse ....)

Specialty (If Applicable)

Phone

Address

Receiver's Information

Name

Function

Phone

Medical Query

This query represents an Adverse Event case:

Download Offline Form

(for medical enquiries in Lebanon) and to +961 1 882 090 (for medical enquiries other than Lebanon) For medical queries, please fill up the Medical Query (MQ) Form and click on Submit.
You may print the MQ Form, whether empty, partially filled or filled.
Forms may be faxed to +961 4 444 275 Forms may be printed here, scanned and mailed to medinfo-pv@mecapharma.com otherwise call our hotline on +961 76 115 444.