Northrop Grumman - Defining the Future
    
  Subscribe to MedDRA
-  Subscription Types
-  Rates
-  Subscription Agreement
-  Translations
-  MedDRA Demo
  Training
  Downloads
  Standardised MedDRA
     Queries (SMQs)
  MedDRA/J
  New Subscriber
       Information
  Announcements/
       Feedback
  MedDRA Services
  Activities & Events
  Documentation Library
  EudraVigilance/
     Regulatory Status
Home > Subscribing to MedDRA > MedDRA Subscription Application > Online Subscription Form
Online Subscription Form
   
  Click here to view Payment Policy.

By filling out this form and pressing the view form button, you will receive an online print version MedDRA subscriber agreement which has to be signed and returned to MSSO. If company is not publicly traded, please provide financial information regarding revenue with your application.

Subscription Point of Contact: (* Required Field)

Organization Name: *
Street Address: *
City: *
State: *
Country: *
Postal/ZIP Code: *
Contact Person: *
Contact Phone: *
Contact Fax: *
Contact E-mail: *

Billing Point of Contact (if different):

Name:
Phone:
Address:
Fax:
City:
State:
Country:
Postal/ZIP Code:
Billing Contact E-mail:

Please Select Subscription Type (subject to verification by the MSSO):
If company is not publicly traded, please provide financial information regarding revenue with your application.

Basic Only- (Basic license, updates only)(Non-Profits)
System Developer (No change requests)
Core Service

Please Select Business Type:
Academia Medical Device
Biotechnology Non Profit
CRO Pharmaceutical
Government Non Regulatory Regulator
Hospital Software Developer
Other

Alternate Point of Contact (if different):
Name:
Phone:
Address:
Fax:
City:
State:
Country:
Postal/ZIP Code:
Alternate Contact E-mail:

   
 
    Site Updates | Home | About Us | Careers | FAQs | Relevant Links | Search | Site Map | Contact Us | Acknowledgements

    Copyright © 2009 Northrop Grumman Corporation. All Rights Reserved