Pharmaceutical Company Representative Contact Request Form

This form is for pharmaceutical industry representatives wishing to request an appointment with the NECS Medicines Optimisation Team.

Requests for appointments will be considered on an individual basis and representatives will be contacted if an appointment is to be made (one product per appointment, maximum visit 30 minutes).  A request for an appointment will not guarantee that an appointment will be arranged.

The requests will be triaged by the MO team to determine whether the request to discuss a particular product or initiative will meet the priorities of the CCG or would benefit the work scheduled in the prescribing committees within the localities.

A pharmaceutical representative will not normally be given another appointment to discuss the same product(s) within a 6 month period unless agreed at a previous meeting or new (and significant) information has become available. This will facilitate equality of access for all pharmaceutical companies within limited resources.  The number of representatives expected to attend the meeting must be stated on the form below.  Additional representatives who arrive for allocated appointments may be asked to leave or the appointment may be cancelled