Healthcare Professional Comment A copy of your answers will be emailed to you. Your name and email address will not be published or publicized.Report share code(Required)Unique alphanumeric code located on the RxISK report that you are providing input for.Your name(Required)Email(Required) Enter Email Confirm Email I am a(Required) Medical Doctor Pharmacist Nurse Other How likely do you think it is that there is a link between the suspect drug and the reported primary side effect?(Required) Very likely Somewhat likely Unlikely I don’t know what is causing it If unlikely I think it is more likely linked to the patient’s original condition I think it is more likely linked to another drug Other CommentsThis field is hidden when viewing the formAddress (medical practice, hospital, pharmacy, etc.)CAPTCHA Δ
