Emergency Contact Information Form

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Health Products and Food Branch Inspectorate
Graham Spry Building, 2nd Floor
250 Lanark Avenue
Address Locator #2002A
OTTAWA, Ontario
K1A 0K9

Dear Sir/Madam:

As per section C.01A.005(b) of the Food and Drugs Regulations, you are requested to submit in writing your emergency contact information (24/7 or after business hours).

Please include the requested information with your 2012 annual review documents.

Emergency Contact Information (24/7 or after business hours)

Company name:

Contact name:

Email:

Establishment Licence Number:

Telephone:

Fax:

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