Pharmaceutical Company Medical Information Services
Midlands
ISSUE REPORTING
Please use this form to report any adverse dealings with Medical Information Departments of
pharmaceutical companies. These will be treated in confidence, and only disclosed to the company in
question with your approval.
MI Centre:
Date of issue:
Company:
Query Title/ No
(from MiDatabank)
Issue type:
Tick or Y
Communication
/language
Error
Inadequate
information
No/ late
response
Other
Issue description/comments
Outcome
Resolved OK
Resolved
unsatisfactorily
Still pending
OK to disclose
to company
Check before
disclosing
Anonymise before
disclosing
Tick or Y
Confidentiality
Tick or Y
Return by email to clare.nelson@uhl-tr.nhs.uk