Report a potential product defect

Are you a…

Are your reporting on behalf of someone else?*

If permitted by local regulations, do you want to be informed about the outcome of the complaint investigation?

Genentech has legal obligations to record and/or report product complaints. As part of this process, we will collect personal information about you, and/or another patient's personal information (if you are reporting on behalf of the patient), information about our products that you or your patient used, and any other information pertaining to the product complaint you or your patient experienced for regulatory purposes, and our internal business and legal purposes. We will not sell this information nor will we share it for purposes of targeted advertising.

If you are a resident of a US state that provides certain rights with respect to your personal information, a complete description of the personal information we may collect and process and your rights under your state's privacy laws concerning your personal information can be found in our privacy notice at https://www.gene.com/privacy-policy

Product selection

For which Genentech product do you have a complaint?

Do you suspect a product falsification?*

Product Information

Product selected

Please select the procedure to which your concern relates:*

Please select your product type (dosage form).*

Is your product available for return?

Complaint Details

What exactly is wrong with your Genentech product? Upload photos of the defect.

How is it different from "normal"? Please add a detailed description of the defect (e.g. appearance, damage, leakage).

Describe when exactly you discovered the defect (e.g. when opening the box, before the administration, after the administration, at which handling step according to instructions of use or patient information leaflet)

Complaint Details Continued

How was the product stored?*

How long have you/patient/caregiver been using the product?*

Was the product administered at home or in a medical environment (e.g. doctors office)?*

By whom?

Did the administrator of the product receive any handling training?*

Has this complaint also been reported via an additional channel (e.g. Health Authority / Call center/ Pharmacy)? *

Have there been any side effects involved?*

Personal Details

Are you a…

Are your reporting on behalf of someone else?*

If permitted by local regulations, do you want to be informed about the outcome of the complaint investigation?

Product selection

For which Genentech product do you have a complaint?

Do you suspect a product falsification?*

Product Information

Product selected

Please select the procedure to which your concern relates:*

Please select your product type (dosage form).*

Is your product available for return?

Complaint Details

What exactly is wrong with your Genentech product? Upload photos of the defect.

How is it different from "normal"? Please add a detailed description of the defect (e.g. appearance, damage, leakage).

Describe when exactly you discovered the defect (e.g. when opening the box, before the administration, after the administration, at which handling step according to instructions of use or patient information leaflet)

Complaint Details Continued

How was the product stored?*

How long have you/patient/caregiver been using the product?*

Was the product administered at home or in a medical environment (e.g. doctors office)?*

By whom?

Did the administrator of the product receive any handling training?*

Has this complaint also been reported via an additional channel (e.g. Health Authority / Call center/ Pharmacy)? *

Have there been any side effects involved?*

Personal Details

Are you a…

Are your reporting on behalf of someone else?*

If permitted by local regulations, do you want to be informed about the outcome of the complaint investigation?

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