Clinical Trials Inquiries
(Healthcare Professionals)

This form is intended for inquiries regarding clinical trials.
Please note that we do not respond to requests for advertising or businesses referrals.

We will respond to inquiries during our working hours. Depending upon the details of the inquiry, if the response takes a considerable time, it may be by telephone, etc. However, we will strive to respond to all inquiries. If no response is made to an inquiry, this may be due to a system failure, or to a mistake in the inquirer's e-mail address, etc. Our e-mail responses will be sent to the addresses of the individual inquirers. We will under no circumstance send inquiries to a third party, or use them for any other purpose.

Name

Name of institution

Name of department

Address of institution

Telephone Number

E-mail address

E-mail address
(Confirmation)

Comment or Question

Chugai Pharmaceutical collects the above personal information for the legitimate interests of both Chugai website users and our company. The personal information collected is handled appropriately in accordance with the Chugai Pharmaceutical Privacy Policy.

This form is intended for inquiries regarding clinical trials. Please note that we do not respond to requests for advertising or businesses referrals.