Medication Sampling Procedure
Pre-Approval Procedures
Sampling Proposal Letter - Template.docxSampling Proposal Letter - Template
Google Form - Request to Use Medication Sample at UMMC
Note: After clicking 'Submit' on the Google Form, a message, as the following, will appear.
Your application has been partially submitted.
Important: Please complete the following instructions to finalize the application process. These steps are essential for completing the application process. Failure to comply may result in the rejection of your application.
1. Check Email: Ensure to check your email inbox for a confirmation regarding your submitted Google Form.
2. Print Google Form: Generate a hard copy of the submitted Google Form.
3. Obtain Signatures: Obtain the necessary signatures from relevant personnel, which include the requestor, head of the unit, or head of the department. Ensure that all required signatures are acquired.
4. Submit to Pharmacy Office, 1st Floor Menara Utama: Deliver the signed hard copy of the Google Form to the Pharmacy Office situated on the 1st Floor of Menara Utama.
If you have any inquiries or encounter difficulties, please contact the Drug Information Centre tel: 03-79493977 / 2407 email: dic@ummc.edu.my Thank you for your cooperation.
Please take note of the important information highlighted.
Post-Approval Procedures
Doctors - Patient Understanding & Responsibilities
1) Obtain patient consent:
Medication samples are provided free of charge by pharmaceutical companies and are not purchased by UMMC
UMMC is not responsible for supplying these drugs if the sampling period is terminated
The continuation of treatment depends on the patient’s clinical condition and the availability of offers from the company. Doctors may prescribe alternatives in the UMMC Formulary for the same disease (indication) to ensure the continuity of treatment.
Patients cannot make any claims in the event of adverse effects resulting from the use of medication samples.
2) Fill out and submit this Google Form twice a year:
Google Form - UMMC Medication Sample Evaluation Form
Note: This form is for UMMC staff use only.
3) Spontaneous reporting:
Google Form - UMMC ADR/AEFI Reporting
Note: This form is for UMMC staff use only.
Last Reviewed Date: 7-Mar-2025
Last Reviewed By: NSS