Medical Inquiry

All fields are required unless otherwise specified

This form is for use by healthcare professionals to request information from U.S. Medical Affairs at Takeda. Adverse Events and Product Quality Complaints must be reported immediately by telephone by calling 1-877-TAKEDA-7 (1-877-825-3327).

By hitting "submit", you are confirming that your request(s) and/or question(s) was (were) not prompted or solicited by anyone at Takeda.

In order to respond to your request, it is necessary to collect and process the personal information you have provided to Takeda. This data will be provided to the appropriate departments within Takeda to address your inquiry. All the information you provide will be retained in accordance with the latest applicable Data Protection laws for a period necessary to comply with the purposes for which your data has been provided. For more detailed information on how Takeda processes personal data, please refer to Takeda’s Privacy Notice at https://www.takeda.com/privacy-notice.

Transfer of Value (TOV): Response(s) may include published literature which are subject to reporting in accordance with Sunshine Act (Open Payments). Takeda is obligated to report HCP transfers of value to certain states and the federal government. Should literature with an assigned value be included with the response(s), how would you like us to fulfill the request:

Please complete your information below and then press the "Submit" button to enter your information.