Medical Information Request

Thank you for your interest in receiving medical information from Omeros. Please contact our medical information services via phone or email at:

Medical Information
Phone: 844-580-7137
Email: medinfo@omeros.com

If you are a US healthcare professional, you can submit your request by completing the form below.

If you are a patient or caregiver and would like to request information related to an Omeros product, you are encouraged to contact your healthcare professional directly.

To report SUSPECTED ADVERSE REACTIONS related to an Omeros product, contact Omeros Corporation at 1-844-OMEROS1 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Medical Information Request Form

This form is intended for US healthcare professionals only.

Name(Required)

Degree

Specialty

Institution

Department

Address

City

State

Zip

Phone

Fax

Email(Required)

Preferred method of response (check all applicable boxes)

Standard mail

Phone call

Medical science liaison fulfillment

Other

Other method of response

Product(Required)

Question or request

Omeros will process the personal information you provide in agreement with the Omeros' privacy statement available at https://www.omeros.com/privacy-policy/. Do not include Sensitive Personal Health Information as defined by HIPAA in the body of your requests. Please provide your contact information and a brief description of your requests. The requests must be associated with Omeros products only. By acknowledging below, you agree to being contacted via mail, email, fax or telephone by Omeros or its affiliates. Your information may be stored in databases or files that are maintained by or on behalf of Omeros for the specific purpose of responding to your requests. Because affiliates of Omeros may be located outside of the US, your personal information may be transferred outside of your country or region, where privacy laws may be different to those in your country or region.

Responses to unsolicited requests by healthcare professionals for scientific or medical reference publications will adhere to applicable regulations. When responding to publication requests, Omeros will either provide a link to an Open Access article or provide the reprint, in PDF format or hard copy. With each response, copyright laws will be protected, and the fair market value of the reprint will be reported in accordance with Sunshine Act requirements. If you have any questions about the Sunshine Act reporting requirements for scientific or medical reference publications, please contact Omeros Corporate via the ‘Contact Us’ page.

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Medical Information Request

Medical Information Request Form

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