Advertised Medicinal Product Complaint Form
All relevant fields must be filled in before the form can be accepted and your complaint investigated.
1. Complainant details:
Signature of complainant: (if you use online submission, please use the Declaration Form)
Kindly fill in the Declaration form at the following link http://www.medicinesauthority.gov.mt/onlineapplications
A Declaration form should be submitted for each signatory.
2. Advertisement details:
Name of medicinal product advertised:
Name of company/ advertiser:
Address of advertiser (if known):
Media in which advertisement appeared:
AV004/04 Appendix 1 Version 1
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