Whistleblowing contact form

This Whistleblowing Contact Form allows you to make a report to Norgine in relation to known or suspected wrongdoing involving Norgine that has occurred or is likely to occur, including attempts of wrongdoing and measures intended to conceal wrongdoing. Relevant wrongdoing may include criminal activity, failure to comply with any legal obligation, regulatory requirements or any applicable code of conduct in the pharmaceutical industry, miscarriages of justice, danger to health and safety, damage to the environment, bribery, facilitating tax evasion, financial fraud or mismanagement, breach of our internal policies and procedures and unauthorised disclosure of personal data or confidential information.

This form is not meant to be used for product quality or safety concerns. If you would like to report a possible side effect (adverse event), please follow the instructions under “Contact us – Report an adverse event”.

When submitting your report via this Whistleblowing Contact Form, the recipients of your report are Norgine’s Compliance Manager, Senior Director Due Diligence, Chief Legal Officer and Chief Financial Officer. Your report will be handled in accordance with Norgine’s Whistleblowing Policy.

    All fields marked * are mandatory

    1. Issue Details and Involved Parties

    Description*

    Who was involved?*

    2. Issue Date and Location

    Where did the issue occur?*

    When did the issue occur?*

    3. Photos or File Uploads

    4. About you

    Name*

    Email*

    Phone

    Preferred contact method

    5. Relationship to the company

    Other*

    Your consent