Notification Form / Conditions for Provision of Packaging/Labelling Services for Drugs under Foreign Ownership (GUIDE-0067)
(May 1st, 2004)
Contact: Drugs GMP Inspection Unit
Tel: (613) 957-1492
Fax: (613) 952-9805
E-Mail: GMP_questions_BPF@hc-sc.gc.ca
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Notification Form
Part 1 - Notification to Health Canada prior to shipment to Canada
Contract packager-labeller
Name:
Address:
City:
Postal Code:
Telephone:
Fax :
Drug to be packaged/labelled
Name (active ingredient):
Brand name:
Quantity:
Manufacture date
Foreign fabricator
Name:
Address:
City:
Country:
Expected date of entry into Canada
Port of entry in Canada
Expected date of return to the fabricator
Part 2 - Notification to Health Canada after the return of the drug to the foreign owner
Quantity packaged
Type and format of packaging material
Quantity of drug per packaging unit
Number of units packaged
Quantity of packaged units returned to the fabricator
Date of return
Transport Mode
If discrepancies, please explain:
Signature :
Page details
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