Global Medical Information

Medical Information Request Form – Healthcare Professional

This page is intended for Healthcare Professionals and other relevant decision makers in New Zealand.

This form is NOT intended to report Adverse Events and/or report Product Quality Complaints.

Please fill out the form below with your information and question and a member of our team will be in touch.

Inquiry Form

Your Contact Information

All fields marked with an asterisk (*) are required.

Country

Salutation

Please specify

First Name

Last Name

Email Address

Phone Number

Phone number is required in the event additional information is needed to clarify your question.

Preferred Response

Email

Phone Call

Fax

Mail

Fax Number

Address Line 1

Address Line 2

City/Town

State/Province

ZIP/Postal code

Healthcare Professional Type

Physician

Pharmacist

Nurse

Other Healthcare Professional

Specialty

Your Enquiry

Which Novavax product does your question relate to?

If you have questions regarding multiple Novavax products, please complete a separate Medical Information Request Form for each Novavax product.

Please specify

Question

Please do not provide any personal information within this field that could identify an individual.

By submitting this form, you agree that this enquiry is unsolicited and that you are a Healthcare Professional.

Novavax respects and recognises your privacy. The information you provide will be used to process your medical information request. In compliance with the Sunshine Act, when a US licensed physician requests a journal article, the value of the article, along with shipping costs if mailed, may be subject to reporting. This information may be shared with affiliates and partners. Your information will be treated in accordance with Novavax’s Privacy Policy.

You may also

Report an Adverse Event (AE)

If you are concerned about an adverse event it can be reported directly to the New Zealand Pharmacovigilance Centre (NZPhvC) via their adverse event reporting site https://nzphvc.otago.ac.nz/reporting/.

Alternatively, adverse events of serious concern in association with a Novavax product can be reported to Novavax Pharmacovigilance at +64 4 974 9419 or via the Novavax Adverse Event Reporting Form.