Donation or grant support enquiry
Thank you for your interest in receiving a donation or grant from Pfizer.
A member of our team will be in touch with you shortly.
Upon submission, Pfizer will undertake an assessment of your request and respond to you in a timely manner.
Note: This form is for donations and grants requests only. To contact Pfizer for any other purpose, including reporting of adverse events, medical information requests or data protection enquiries, please call 01304 616161. Note that any adverse events reported to Pfizer should also be reported to the MHRA. See https://yellowcard.mhra.gov.uk for further information.
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Full Name *
Contact email address *
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Name of healthcare organisation that will be the recipient of the donation or grant *
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Donation or Grant Information
If you have discussed potential delivery of the selected programme with a Pfizer Account Manager, please enter the Account Manager's name.
What is the proposed start date of the project?*
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