Medical Information Form

Bayer takes the protection of your personal data very seriously and will store your data in accordance with the local applicable laws and internal Bayer policies. Your information will be stored for the purposes of recording your request for medical information and following up with you, should this be necessary. Your personal information will be stored on a secure database at our company, which will stay with data processors or servers acting on our behalf and responsible to us. Where this data is transferred to Bayer affiliates in other jurisdictions, we will ensure that appropriate protections are in place to maintain the same protection of that data. The data will be stored for as long as we require the information in order to deal with your query or for as long as we are legally permitted. Should you wish to access, correct, verify or delete any of your personal information, please contact


Please fill out the appropriate fields, with your preferred contact method details (Telephone or email). Fields marked with (*) are mandatory.