Information Services Inquiry

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Privacy notice statement

Security notice: Up to Protected B only

This site is not approved by HC/PHAC for storage above Protected B information. Only up to Protected B information may be stored on this site.

Instructions

Instruction 1

Submitter

Provide the contact information of the submitter of the inquiry. This information can be used as detailed in the Privacy Notice Statement.

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Instruction 2

Products

Provide information on the product, such as its name, registration number, or active ingredients. You may select up to 3 products.

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Instruction 3

Inquiry

Select the subject of the inquiry and provide details. Please be clear and specific. Do not include information in the report form that could lead to the identification of an individual. Please limit your inquiries to products regulated under the PMRA Mandate, for example, Herbicides, Insecticides, Insect repellents, Fungicides, Rodenticides, Swimming pool bactericides/algicides.

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Instruction 4

Attachments

Attach any files you wish to include with the online form.

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1. Submitter^{Instruction 1}

Type of organization (required)

Other type of organization (required)

Company name

Title / Position

First name (required)

Last name (required)

Address

City

Country

Other country (required)

Province

State

Region

Postal code / Zip

Telephone (including area code) (required)

Telephone (including country code) (required)

Email address (required)

Confirm your email address (required)

2. Products^{Instruction 2}

You can have up to 3 pesticide products. Click on the "Add more products" button to add additional products. Click on the "Remove Product" button to remove a product.

Product # {{$index + 1}}

Product information (required)

Registration number (digits only) (required)

Product name (required)

Active ingredients (maximum of 500 characters) (required)
{{500-product.activeIngredients.length}}

3. Inquiry^{Instruction 3}

Subject (required)

Other subject (required)

Describe issue in detail (maximum of 2,000 characters) (required)
{{2000-inquiry.issueInDetail.length}}

4. Attachments^{Instruction 4}

Note: There is a known issue with Internet Explorer that may impact your ability to upload attachments. If you experience any difficulties in uploading attachments, please try one of the following:

Use another browser,
Close and restart Internet Explorer, or
Restart your computer.

Add any additional attachments you wish to include in the online form.

I have read, understood and agree with the Privacy notice statement (required)Privacy notice statement

I have read, understood and agree with the Security notice (required)Security notice

Information Services Inquiry

Privacy notice statement

Security notice: Up to Protected B only

Instructions

1. SubmitterInstruction 1

2. ProductsInstruction 2

Product # {{$index + 1}}

3. InquiryInstruction 3

4. AttachmentsInstruction 4

1. Submitter^{Instruction 1}

2. Products^{Instruction 2}

3. Inquiry^{Instruction 3}

4. Attachments^{Instruction 4}