CARPHA > CRS Application

CRS Application

First Name

Enter first name

Last Name

Enter last name

Enter email

Company Name

Enter company name

Country

Select country

Trade Name

Enter trade name

International Non-proprietary Name

Enter International Non-Proprietary Name

Strength

Enter strength

Dosage Form

Enter dosage

Applicant Type

Select applicant type

Application for CRS Review of

Amount

Application Fee

** Application fees shown include a transaction fee of $15.00.