SUBMIT MEDICAL ENQUIRY

ENQUIRY INFORMATION

*Required Fields

PLEASE ENTER THE RELEVANT ASCENDIS PRODUCT*

ENTER YOUR QUESTIONS HERE*

Please be specific but do not include any information which can be used to identify an individual (“Personal Data” as defined under GDPR) or information related to safety reporting) If your enquiry is urgent, please call +44 20 4570 1942.

SELECT THE OPTION THAT BEST DESCRIBES YOU*

HOW WOULD YOU PREFER TO RECEIVE A RESPONSE
FROM ASCENDIS PHARMA?*

contact information

NAME:

First Name*

Last Name*

EMAIL &
TELEPHONE:

Email*

TELEPHONE*

By submitting this enquiry, I certify that I initiated the request for information
and this request was not solicited by an Ascendis Pharma employee/
representative. I furthermore acknowledge that the information I provide will
be treated in accordance with Ascendis Pharma A/S's Privacy Policy.

ENQUIRY INFORMATION

*Required Fields

PLEASE ENTER THE RELEVANT ASCENDIS PRODUCT*

ENTER YOUR QUESTIONS HERE*

Please be specific but do not include any information which can be used to identify an individual (“Personal Data” as defined under GDPR) or information related to safety reporting) If your enquiry is urgent, please call +44 20 4570 1942.

SELECT THE OPTION THAT BEST DESCRIBES YOU*

HOW WOULD YOU PREFER TO RECEIVE A RESPONSE
FROM ASCENDIS PHARMA?*

contact information

NAME:

First Name*

Last Name*

DEGREE &
SPECIALTY:

DEGREE*

SPECIALTY*

EMAIL &
TELEPHONE:

Email*

TELEPHONE*

By submitting this enquiry, I certify that I initiated the request for information
and this request was not solicited by an Ascendis Pharma employee/
representative. I furthermore acknowledge that the information I provide will
be treated in accordance with Ascendis Pharma A/S's Privacy Policy.

Welcome to Ascendis Pharma Medical Information

A resource dedicated to providing scientifically balanced medical information on Ascendis Pharma medicines to support informed clinical decisions for patient care.

I AM A

HEALTHCARE
PROFESSIONAL PATIENT OR
CAREGIVER

Please call +44 20 4570 1942 to report adverse events or product complaints or to speak to a Medical Information Healthcare Professional directly.

Please review our Terms of Use and Privacy Policy before proceeding. By submitting your inquiry you agree to our Terms of Use policy.