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  • Side Effect
  • Product
  • Whose side effect
  • Contact details

Side effects

Please tell us about the side effect you want to report.

What is the side effect you want to report?* Required Describe the side effect below.

About the side effect

What was the outcome of the side effect? *Required

Describe the side effect in more detail and if any treatment was needed

Product related

What is the name of the iNova product you want to report?* Required Type the full name of the product below eg: Dermaveen Daily Nourish Moisturising Lotion

About this product

Why did you use this product?

Which formulation of the product were you taking?

Please specify others here:

How did you use it?

Please specify others here:

How often did you use it?

Lot or Batch number and Expiry Date You can find this number on the packaging of the product.

About the person experiencing the side effect

Who experienced the side effect? * Required.

What is the gender of the person experiencing the side effect? * Required.

Tell us more... The rest of the questions on this page will give us more information so that we can understand about the side effect and help others with similar issues.

What are the initials of the person who experienced the side effect?

Are they of Aboriginal or Torres Strait Islander and/or South Sea Islander descent?

How old were they at the time of the side effect?

What was their height? *cm

What was their weight? *kg

Does the person have any other health or medical conditions?

Please give any additional information that you think is relevant

We respect your privacy. Any personal information that you have provided will be collected and used to assist you with your medical enquiry and/or may be used to report adverse events relating to our products in accordance with our regulatory obligations. We may share that information with regulatory authorities or third parties that we engage to process adverse events and enquiries on our behalf. We may also use the information to maintain records of enquiries and reports and to investigate or follow up on your enquiry or report. If you are providing us with someone else’s personal information, you confirm that you have obtained their consent to do so.
You can view further details on how we manage personal information in our privacy policy at www.inovapharma.com/privacy. If you have any questions or concerns regarding the management of your personal information, please contact privacy@inovapharma.com.

Reporter and contact information

What is your email address?

What is your best contact phone number?

What is your country? * Required.

Can we contact you if we need more information about your report? If you consent for iNova to contact you, we will via the email address provided above

Can we contact the treating healthcare professional (HCP) if we need more information about the event(s) reported? Please provide contact details of the treating HCP and follow-up with the HCP will preferably be via the email address provided below.

Treating HCP name

Treating HCP email address

Treating HCP phone number