Submit Medical Inquiry

This form is intended for US healthcare professional use only. If you are a patient or caregiver and would like to request information about Seqirus products, please contact your healthcare professional.

If you have encountered any Adverse Event(s) from a Seqirus product, please enter the details below.

Please complete the form below. Fields marked with an asterisk (*) are required.

Report an Adverse Event and Product Complaint

To speak with a Medical Information Professional about our product, report an Adverse Event or Product Complaint please contact us at: 1-855-358-8966

Or VAERS – Vaccine Adverse Event Reporting System

Phone: 1-800-822-7967 or visit: https://vaers.hhs.gov/