Nomination form for Active Member for the Natural Health Products Program Advisory Committee

The Natural Health Products Directorate (NHPD) has changed its name to the Natural and Non-prescription Health Products Directorate (NNHPD) subsequent to its recently expanded mandate to include the oversight of non-prescription and disinfectant drugs in addition to natural health products (NHPs). Please note that we are currently modifying documents to reflect this change.

Thank you for your patience and understanding.

(PDF Version - 29 K)

Section 1: Nominee Information

Prefix (Mr./Mrs./Ms./Dr.)

First Name

Last Name



Title or designation, if applicable

Street Address



Postal Code


  • Work
  • Cellular
  • Other (please specify)


  • Work
  • Other (please specify)

E-mail address

  • Work
  • Other (please specify)

Preferred language for future communications

  • English
  • French

Section 2: Nominee Areas of Representation

A. Network or Association, check all that apply

A network is defined as an "association of independent individuals, organizations and/or communities of interest whose primary purpose is forming a strong community in order to gain strength and perform as a significant player in relation to current market situations."

  • National
  • Provincial
  • Regional
  • Other (please specify)

B. Sector, check all that apply:

  • Patient and Consumer Group
  • Industry
  • Health and Regulatory Sector
  • Research/Academia
  • Retail
  • Other (please specify)

C. Represented Enterprise, check all that apply

  • Small/Medium
  • Large
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