Medical Information Request

This form is not intended for reporting adverse events. Please report adverse events to adverse_events@beigene.com.

In the name of protecting patient privacy and ensuring compliance with applicable laws, we request that you do not share any patient identifiable information (e.g., name, initials, date of birth, etc.) in connection with your medical information request. In accordance with BeiGene policies, we cannot provide medical advice with respect to particular patients.

BeiGene and its affiliates respect your privacy. As such, any personal information you provide to us will only be used for purposes of processing your medical information request and in accordance with applicable laws. Please see BeiGene's Privacy Policy at
https://www.beigene.com/privacy-policy for additional information about our data protection practices.