Send the downloaded and completed PDF form to the email address pv@usp.pl,
and the original by registered mail to the address:
US Pharmacia Sp. z o.o.
ul. Poleczki 35,
02-822 Warsaw
IMPORTANT! On the envelope, please write: “ADVERSE DRUG REACTION”
Patient or their caregiver
Reporting an adverse reaction in oneself or a member of the immediate family. Legal or actual guardians and legal representatives of the person who experienced such a reaction may do so.
A person practicing a medical profession
Reporting an adverse event in a patient. Form for doctors, dentists, pharmacists, pharmacy technicians, nurses, midwives, laboratory diagnosticians, paramedics, feldshers (senior feldshers).
Other ways to report adverse effects
We also accept applications by phone. If you have any questions or concerns, please feel free to contact us:
An adverse reaction can also be reported by contacting the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products.