Medicines Information Enquiry Form

 

Healthcare professionals in the South West region of the UK may use this form to submit medicine related enquiries to South West Medicines Information Centre.

If you would like to speak to us directly or your enquiry is urgent, please phone: 0117 342 6655 between 8.45am-5pm Monday to Friday

Please note: * indicates mandatory field

Your Contact Details




Your Enquiry Details
If yes, please provide the following information:
Patient Details

Please include if:

  • Pregnant - How many weeks pregnant?
  • Breastfeeding - Age of baby and if born full term and healthy
  • Abnormal kidney function - eGFR or CKD stage
  • Abnormal liver function - LFTs





Please state your enquiry in a clear and precise manner, providing as much information as possible to enable us to answer your enquiry. Use the categories in the Adapted Quick Question Guide to help identify additional background information we need to answer your enquiry.