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FORM 8 ADVT — Application for advertisement of medicine or allied substance

Currentness under review. Whether this instrument remains applicable is under review. Consult the later instruments and source context below before relying on it.

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Contents

FORM 8 ADVT APPLICATION FOR ADVERTISEMENT OF MEDICINE OR ALLIED SUBSTANCE 1. Particulars of Applicant: (1) Name of applicant ………………………………...…………………………………………………. (2) Physical address/location………………………………………………………………………... (3) Postal address ………………………………………………………………………………………… ………………………………………………………………………………………………………………. (4) E-mail address………………………………………………………………………………………. (5) Full name and title of signatory………………………………………………………………… ………………………………………………………………………………………………………………. 2. Description of Advertisement: (1) Type of activity (ies) for which application is made (Example launch, advertisement, talk-show, exhibition,) …………..…..……………………………………………………………………. (2) Type of material (s) to be used (Attach 2 samples) (Example: posters, literature, bags, calendars, audio, video) ……………………………………………………………….…………………… (3) Medicine or allied substance name …………………………………….…………………….. (4) Language of the publication or advert…………………….…..…………………………….. (6) Intended target group (Example: Healthcare professionals, general public) ………………………………………………………………………………. (5) Date of application…………………………….… Signature …………………………

FORM 8 ADVT — official PDF page 1; original table columns, symbols and diagram connections
FORM 8 ADVT — official PDF page 1; original table columns, symbols and diagram connections

3. For Official Use Only (1) Fees payable……………………………………….. (2) Receipt No………….………………………………. Date…………………………………… (3) PMRA entry No……………………………………………. (4) Application and samples received by (name)…………………………………………….. Signature…………………………………. Date…………………………………

FORM 8 ADVT — official PDF page 2; original table columns, symbols and diagram connections
FORM 8 ADVT — official PDF page 2; original table columns, symbols and diagram connections