Medication Disclosure Forms

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Medicine and Occupational Health (MOH) Country and Site Phone Numbers (Password protected, same as the Medication Information Database)

MOH E-mail Addresses (Password protected, same as the Medication Information Database)

Please send the form to your country or site's MOH email address with your name and indicate that this is a Medication Disclosure on the subject line for ease of processing by MOH.

Medication Disclosure Forms

Angola
• Portuguese
• English

Argentina
• Spanish
• English

Australia

Belgium
• Dutch
• English
• French

Brazil
• Portuguese
• English

Cameroon

Canada
• English
• French

Chad
• French
• English

China
• Simplified Chinese
• English

Colombia
• Spanish
• English

Cyprus
• Greek
• English

Egypt

Equatorial Guinea
• Spanish
• English

Fiji

Finland
• Finnish
• English

France
• French
• English

Germany
• German
• English

Guadeloupe
• French
• English

Guam

Hong Kong
• Chinese
• English

Indonesia
• Indonesian
• English

Ireland

Italy

Malaysia

Martinique
• French
• English

Mexico
• Spanish
• English

Netherlands
• Dutch
• English

New Caledonia
• French
• English

New Zealand

Nigeria

Norway
• Norwegian
• English

Papua New Guinea

Peru
• Spanish
• English

Qatar
• Arabic
• English

Russia - Sakhalin
• Russian
• English

Saudi Arabia
• Arabic
• English

Singapore

South Korea
• Korean
• English

Sweden
• Swedish
• English

Taiwan
• Chinese
• English

Thailand
• Thai
• English

Turkey
• Turkish
• English

United Arab Emirates
• Arabic
• English

United Kingdom

United States