Medical Information Requests
 
Please provide the following information for your query. These requests are for healthcare professionals in the United Kingdom only. Alternatively, you can contact us at medinfoglobal@shire.com.
 
The following information is required to fulfill your medical information request. We will not use this information for marketing purposes. Fields marked with an * asterisk are mandatory.
 
Date 21/05/2012
 
First Name*  
Surname*  
 
How would you like to be contacted?*  
 
Email address*  
Verify email address*
 
Address*  
 
City*  
Postcode*  
 
Phone number
 
Product*  
If "other" please specify  
 
Information required*  
 
How will you use this information?*  
 
Data protection* Please read the Shire Privacy Policy for information about the use and protection of your personal data.