{"id":12377,"date":"2017-11-23T14:20:46","date_gmt":"2017-11-23T14:20:46","guid":{"rendered":"https:\/\/celonpharma.com\/?page_id=12377"},"modified":"2017-11-24T10:29:15","modified_gmt":"2017-11-24T10:29:15","slug":"for-the-patient","status":"publish","type":"page","link":"https:\/\/celonpharma.com\/en\/for-the-patient\/","title":{"rendered":"For the patient"},"content":{"rendered":"<p><span class=\"bold\">Report a drug&#8217;s adverse effect<\/span><\/p>\n<p>This form is intended for patients, if you are a healthcare professional, <a href=\"\">go to the form which was prepared for your needs.<\/a>.<\/p>\n<p><span class=\"bold\"><span class=\"orange-write\">Uwaga:<\/span> Celon Pharma is not authorised to provide medical advice, nor to confirm whether the experienced symptoms have been caused by the drug.<\/span><\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f12379-o1\" lang=\"pl-PL\" dir=\"ltr\" data-wpcf7-id=\"12379\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/12377#wpcf7-f12379-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formularz kontaktowy\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"12379\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f12379-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"patient-form-wrapper\">\n<div class=\"grey patient-form-block form-margin\">\n\t<h6 class=\"bold orange-write uppercase\">DESCRIPTION OF THE ADVERSE EFFECT<\/h6>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"large-6 cell\">\n\t\t\t<label>What adverse effects have you observed, please describe them?*\n                           <span class=\"wpcf7-form-control-wrap\" data-name=\"name-side-effects\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"name-side-effects\"><\/textarea><\/span>\n\n                        <\/label>\n\t\t\tHow severe was the adverse effect? (Please tick the appropriate box to specify how severe the drug's adverse effect was)<br\/>\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"severity-side-effects\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Mild\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Mild<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Unpleasant - allowing for daily activity\" \/><span class=\"wpcf7-list-item-label\">Unpleasant - allowing for daily activity<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Severe - hindering daily activity\" \/><span class=\"wpcf7-list-item-label\">Severe - hindering daily activity<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Severe - medical consultation needed\" \/><span class=\"wpcf7-list-item-label\">Severe - medical consultation needed<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Hospital treatment required\" \/><span class=\"wpcf7-list-item-label\">Hospital treatment required<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Serious medical condition\" \/><span class=\"wpcf7-list-item-label\">Serious medical condition<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"severity-side-effects\" value=\"Resulting in death\" \/><span class=\"wpcf7-list-item-label\">Resulting in death<\/span><\/span><\/span><\/span>\n                        \n\t\t\t<label>Other severity:\n                          <span class=\"wpcf7-form-control-wrap\" data-name=\"other-severity-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"other-severity-side-effects\" \/><\/span>\n                        <\/label>\n\n\t\t<\/div>\n\t\t<div class=\"large-6 cell\">\n<label>When did the adverse effects of the drug start?\n<span class=\"wpcf7-form-control-wrap\" data-name=\"start-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"start-side-effects\" \/><\/span>\n<\/label>\n\t\t\tHow do you evaluate your present health condition? (Please tick the appropriate box)<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"level-health\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"level-health\" value=\"Good (the symptoms have subsided)\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Good (the symptoms have subsided)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"level-health\" value=\"Improvement\" \/><span class=\"wpcf7-list-item-label\">Improvement<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"level-health\" value=\"The symptoms continue\" \/><span class=\"wpcf7-list-item-label\">The symptoms continue<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"level-health\" value=\"Deterioration\" \/><span class=\"wpcf7-list-item-label\">Deterioration<\/span><\/span><\/span><\/span>\n                     \n\t\t\t<label>Other health condition evaluation:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-level-health\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"other-level-health\" \/><\/span>\n<\/label>\n\t\t\t<label>If possible, please provide additional information. (e.g. Have there been attempts to treat the adverse effects? Has the use of the drug been discontinued due to adverse effects to the drug? Have the symptoms subsided after the drug administration was discontinued?)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"add-info-side-effects\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"add-info-side-effects\"><\/textarea><\/span>\n<\/label>\n\t\t<\/div>\n\t<\/div>\n\n       <h6 class=\"bold orange-write uppercase\">DESCRIPTION OF THE ADVERSE EFFECT<\/h6>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"large-6 cell\">\n\t\t\t<label>Who experienced the adverse effect?*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-side-effects\" \/><\/span><\/label>\n<span>\n\t\t\t\tData of the person who experienced the adverse event (Please provide as much information as possible\n\t\t\t<\/span>\n<label>Initials:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"initial-patient-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"initial-patient-side-effects\" \/><\/span>\n<\/label>\n\n\t\t\tSex: <br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gender-patient-side-effects\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"gender-patient-side-effects\" value=\"Female\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"gender-patient-side-effects\" value=\"Male\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/span><\/span><\/span>\n\n\t\t<\/div>\n\t\t<div class=\"large-6 cell\">\n\t\t\t\t\t\t<label>Age:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"age-patient-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"age-patient-side-effects\" \/><\/span>\n<\/label>\n\n\n\n\t\t\t<label>Body weight:<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"weight-patient-side-effects\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"weight-patient-side-effects\" \/><\/span>\n<\/label>\n\t\t\t<label>Other relevant information (for example the disease condition or allergic reaction):\n<span class=\"wpcf7-form-control-wrap\" data-name=\"add-info-patient-side-effects\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"add-info-patient-side-effects\"><\/textarea><\/span>\n<\/label>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"grey patient-form-block form-margin\">\n\t<h6 class=\"bold orange-write uppercase\">DRUGS WHICH COULD HAVE CAUSED THE ADVERSE EFFECTS<\/h6>\n\t<p>\n\t\tPlease provide details about the which could have caused the adverse effect.\n\t<\/p>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"large-6 cell\">\n\t\t\t<h6>Drug used (1)<\/h6>\n\t\t\t<label>(1) Name of the drug:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug-name-1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-drug-name-1\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t(1) Prescription drug?<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug1-prescription\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"patient-drug1-prescription\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"patient-drug1-prescription\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t\n\n\t\t\t<label>(1) (1) Dosage (for example: 1 250 mg tablet twice a day)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-patient-drug1-dosage-1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-patient-drug1-dosage-1\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(1) Reason for use of the drug:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug1-reason\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-drug1-reason\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(1) (1) Date on which treatment was commenced:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-start-treatment1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-start-treatment1\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(1) Date on which treatment was finished:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-end-treatment1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-end-treatment1\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t(1) Was the use of the drug discontinued due to the adverse effect?\n<span class=\"wpcf7-form-control-wrap\" data-name=\"discontinue-use1\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"discontinue-use1\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"discontinue-use1\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t\n\t\t<\/div>\n\t\t<div class=\"large-6 cell\">\n\t\t\t<h6>Drug used (2)<\/h6>\n\t\t\t<label>(2) Name of the drug:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug-name-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-drug-name-2\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t(2) Prescription drug?<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug2-prescription\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"patient-drug2-prescription\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"patient-drug2-prescription\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t\n\n\t\t\t<label>(2) Dosage (for example: 1 250 mg tablet twice a day)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug2-dosage-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-drug2-dosage-2\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(2) Reason for use of the drug:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-drug2-reason\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-drug2-reason\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(2) Date on which treatment was commenced:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-start-treatment2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-start-treatment2\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t<label>(2) Date on which treatment was finished:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-end-treatment2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-end-treatment2\" \/><\/span>\n\t\t\t<\/label>\n\n\t\t\t(2) Was the use of the drug discontinued due to the adverse effect?<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"discontinue-use2\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"discontinue-use2\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"discontinue-use2\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"grey patient-form-block form-margin\">\n\t<h6 class=\"bold orange-write uppercase\">ATTENDING PHYSICIAN<\/h6>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"cell\">\n\t\t\tWould you like this report to be sent to your attending physician?<br\/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"notice-doctor\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"notice-doctor\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"notice-doctor\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"cell\">\n\t\t\t<p>\n\t\t\t\tIf the answer is yes, please provide the full name and address of the physician\n\t\t\t<\/p>\n\t\t\t<label>Name and surname of the physician:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-doctor\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name-doctor\" \/><\/span>\n\t\t\t<\/label>\n\t\t\t<label>Address of the physician:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address-doctor\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address-doctor\" \/><\/span>\n<\/label>\n\t\t\t<label>Postal code of the physician:<span class=\"wpcf7-form-control-wrap\" data-name=\"text-postcode-doctor\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-postcode-doctor\" \/><\/span><\/label>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"grey patient-form-block form-margin\">\n\t<h6 class=\"bold orange-write uppercase\">INFORMATION ABOUT THE PERSON REPORTING THE ADVERSE EFFECT<\/h6>\n\t<div class=\"grid-x grid-margin-x\">\n\t\t<div class=\"cell\">\n\t\t\t<p>\n\t\t\t\tContact details - please provide a full mailing address, phone number, e-mail address\n\t\t\t<\/p>\n\t\t\t<label>Name and surname:*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name-patient\" \/><\/span>\n\t\t\t<\/label>\n\t\t\t<label>Address:*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address-patient\" \/><\/span>\n<\/label>\n\t\t\t<label>Postal code:*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postcode-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postcode-patient\" \/><\/span>\n<\/label>\n\t\t\t<label>Phone number:*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"phone-patient\" \/><\/span>\n<\/label>\n\t\t\t<label>Email:*\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-patient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"email-patient\" \/><\/span>\n\t\t\t<\/label>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"postcontent-form\">\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-637\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"acceptance-637\" value=\"1\" class=\"no-margin\" aria-invalid=\"false\" \/><\/span><\/span><\/span> Personal data collected in connection with the report will be processed by Celon Pharma S.A with its registered address at: ul. Ogrodowa 2a in \u0141omianki, Pursuant to the Act of 10 May 2018 on personal data protection (Journal of Laws of 2019 item 1781) solely for the purpose of meeting the obligation consisting in monitoring of safety of medicinal products.*\n\nPersons reporting adverse effects of medicinal products are obliged to provide their personal data under the Act of 6 September 2001 - Pharmaceutial law (Journal of Laws of 2008, No. 45, item 271, as amended) and other provisions of law. In the case of other persons, providing personal information is voluntary but necessary for the report to be accepted. Everyone has the right to access their his\/her data and correct it.\n<\/p>\n<\/div>\n<div class=\"text-right\">\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner button warining\" type=\"submit\" value=\"Send\" \/>\n<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Report a drug&#8217;s adverse effect This form is intended for patients, if you are a healthcare professional, . Uwaga: Celon Pharma is not authorised to provide medical advice, nor to confirm whether the experienced symptoms have been caused by the drug.<\/p>\n","protected":false},"author":11,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-12377","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>For the patient - Celon Pharma<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/celonpharma.com\/en\/for-the-patient\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"For the patient - Celon Pharma\" \/>\n<meta property=\"og:description\" content=\"Report a drug&#8217;s adverse effect This form is intended for patients, if you are a healthcare professional, . 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