Application form for request of review of educational materials Please fill in the applicable information, tick the appropriate boxes and submit the application form along with relevant documents, by e-mail to IMA (email address: , subject: EDUMAT followed by the medicinal product name). Request for initial review (new/first- time educational materials) Request for repeated review (updated educational materials) Only the Icelandic version of the materials should be submitted but IMA may request the English version if necessary Medicinal product name, active ingredient, strength and pharmaceutical formulation: Original product Generic/biosimilar Marketing Authorisation Holder: Agent (if applicable): Name, e-mail address and phone no. of contact person: Date of planned marketing of the medicinal product (if not already marketed). dd/mm/yy: Date of planned distribution/publication of the educational materials. dd/mm/yy: Clarification of the main amendments/changes of the updated educational materials (repeated submission only): List of all components of the educational materials: Cover-letter (required), List of proposed recipients (by speciality not on a name basis):
Application form for request of review of educational materials Please fill in the applicable information, tick the appropriate boxes and submit the application form along with relevant documents, by e-mail to IMA (email address: , subject: EDUMAT followed by the medicinal product name). Request for initial review (new/first- time educational materials) Request for repeated review (updated educational materials) Only the Icelandic version of the materials should be submitted but IMA may request the English version if necessary Medicinal product name, active ingredient, strength and pharmaceutical formulation: Original product Generic/biosimilar Marketing Authorisation Holder: Agent (if applicable): Name, e-mail address and phone no. of contact person: Date of planned marketing of the medicinal product (if not already marketed). dd/mm/yy: Date of planned distribution/publication of the educational materials. dd/mm/yy: Clarification of the main amendments/changes of the updated educational materials (repeated submission only): List of all components of the educational materials: Cover-letter (required), List of proposed recipients (by speciality not on a name basis):
application_for_educational_material.docx