Patient Associations Sponsorship Application

Please complete the form below giving as much detail as possible. Most of the fields are required. You must upload supporting document in PDF format.

Please provide a detailed description of support requested.
Please describe how this support will benefit patients.
Please describe details of any non-monetary support requested and estimated commercial value, if possible.
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Depending on the nature of your request, we will require backup documentation as set out below to demonstrate our compliance with the IPHA Code of Practice for the Pharmaceutical Industry. If you have any queries regarding what is required, please do not hesitate to contact us.

For a once off project (support for a publication, project or piece of research in which A.Menarini has little or no involvement) we require a detailed description or project plan and cost estimates or quotations justifying the amount requested.

For an organised meeting (support for speaker honoraria, venue costs) we require an agenda, venue details, a copy of proposed invitations or advertisements and cost estimates, clearly indicating proportion to be paid by A.Menarini.

If attending a meeting (contributions towards delegate travel) we require an agenda, venue details, a copy of proposed invitations or advertisements and cost estimates, clearly indicating proportion to be paid by A.Menarini.

Projects of joint interest require a separate contract of support detailing specific responsibilities and costs. If your request is pre-approved, A.Menarini will make contact with you to discuss.

NOTE: Only PDFs may be uploaded.
If requested by A.Menarini you will provide invoices and receipts related to this request to verify compliance with the terms of this Agreement.