Feedback Form

Please complete the feedback form below to report problems experienced in obtaining branded medicines due to Manufacturer’s quota schemes. PSNC will work to ensure this information is fed into the Department of Health as evidence of the ongoing supply problems being reported by pharmacy contractors.

* indicates required field.

*Name

*Name of Pharmacy

*Postcode of Pharmacy

*Country

*Email

*Wholesaler

*Depot

*Product

*Manufacturer

If other, please specify

*Time to obtain product

Summary of problems occurred in obtaining product:
(please fill in as much detail as possible)

Impact of supply issue
(please fill in as much detail as possible)

Please check the box if you consent to PSNC passing on your contact details to the relevant manufacturers if they would like to investigate the report further