We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Fda Form 3500a - Medwatch - Network13

Get Fda Form 3500a - Medwatch - Network13

Print Next Page Reset Form U.S. Department of Health and Human Services Food and Drug Administration For use by user-facilities, importers, distributors and manufacturers for MANDATORY reporting MEDWATCH.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the FDA Form 3500A - MEDWATCH - Network13 online

Filling out the FDA Form 3500A - MEDWATCH - Network13 is essential for reporting adverse events and product problems in a comprehensive manner. This guide provides clear and supportive instructions tailored to users of all experience levels, ensuring successful completion of the form online.

Follow the steps to accurately complete the FDA Form 3500A - MEDWATCH - Network13 online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Complete Section A: Patient Information. Fill in the Patient Identifier, Age at Time of Event, Sex, and Weight. Ensure to enter this information clearly and in the designated fields.
  3. Proceed to Section B: Adverse Event or Product Problem. Choose the appropriate options for B1, B2, and B3. Provide details about the adverse event and any outcomes that are relevant.
  4. In Section C: Suspect Product(s), provide the product name, dosage, and any relevant therapy dates. Include the NDC number if applicable, and any other concomitant medical products in section C10.
  5. Fill out Section D: Suspect Medical Device with the device name, serial number, and related information about its usage and operation.
  6. Complete Section E: Initial Reporter by entering the name, address, and contact details of the individual reporting the event.
  7. If applicable, complete Section F: For Use by User Facility/Importer with the appropriate details based on the type of report you are submitting.
  8. In Section G: All Manufacturers, fill in the necessary details concerning the manufacturer of the product involved in the adverse event.
  9. Finally, review all sections for completeness and accuracy. Users can save changes, download, print, or share the completed form as needed.

Complete the FDA Form 3500A - MEDWATCH - Network13 online today to ensure vital information is reported accurately.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

vocab - MapSales.com - world maps, country maps...
... week 756 data 757 clips 758 legal 759 bill 760 form 761 savings 762 camera...
Learn more

Related links form

PLEASE NOTE It Is Important That You Complete All Parts Of The Application - Jobapplicationform Nonnegotiable(black) Financial Assistance Form - MUSC Health To Be Completed By Reception / Nurse - Nextcare

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

MedWatch, the FDA's medical product safety reporting program for health professionals, patients and consumers. MedWatch receives reports from the public and when appropriate, publishes safety alerts for FDA-regulated products such as: Prescription and over-the-counter medicines.

Form FDA 3500 may be used by health professionals or consumers for VOLUNTARY reporting of adverse events, product use/medication errors, product quality problems, and therapeutic failures for: Prescription and over-the-counter medicines including those administered in a hospital or outpatient infusion centers.

Form FDA 3500 may be used by health professionals or consumers for VOLUNTARY reporting of adverse events, product use/medication errors, product quality problems, and therapeutic failures for: Prescription and over-the-counter medicines including those administered in a hospital or outpatient infusion centers.

FDA Form 3500 and FDA Form 3500B are for voluntary reporting; FDA Form 3500A is for mandatory reporting. * The majority of the indirect, mandatory reports were not received by Agency on a paper version of form 3500A [by mail or fax] but via an electronic submission route.

Form FDA 3500A is used for mandatory reporting (i.e., required by law or regulation), primarily by regulated industry reporters but also for certain User Facility reporters for reports related to deaths associated with medical devices.

A user facility is required to report a device-related death or a device-related serious injury to the manufacturer and to report a device-related death to FDA. • Manufacturers must prepare and submit a complete Form FDA 3500A for each suspect device.

Reporting can be done through our online reporting portal or by downloading, completing and then submitting FDA Form 3500 (health professional) or 3500B (consumer/patient) to MedWatch: The FDA Safety Information and Adverse Event Reporting Program.

The MedWatch form, also known as Form FDA 3500A, is used for mandatory reporting of medical device adverse events by manufacturers, user facilities and importers. Form FDA 3500, a condensed version of 3500A, is used for voluntary reporting of adverse events by healthcare professionals, consumers and patients.

The MedWatch form, also known as Form FDA 3500A, is used for mandatory reporting of medical device adverse events by manufacturers, user facilities and importers. Form FDA 3500, a condensed version of 3500A, is used for voluntary reporting of adverse events by healthcare professionals, consumers and patients.

There are two types of MedWatch forms: MedWatch Form 3500 and MedWatch Form 3500A. MedWatch Form 3500 represents a voluntary reporting form and should be used by consumers, healthcare professionals and patients to report serious adverse events.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get FDA Form 3500A - MEDWATCH - Network13
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232