Reference Guardian Request Form

Reference Guardian Request Form

Response to Reference Guardian Request will be expected in 2-4 days. If unexpected delay occurs, requestor will be notified.

Click here to request a Reference Guardian Request*

Requestor Last Name*

Requestor First Name*

Requestor Email (Please ensure address is correct)*

Agency Name

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Brand (Free text field, if brand not in dropdown)*

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Market*

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Type of Reference Requested:*

Upload PDF copy of these files (Websites, Guidelines, Posters/Abstracts, textbooks, and other attachments (i.e., testimonials, etc.) as part of the reference request e-mail with required information and reference guardians will upload the document to the Binder.
DoFs are considered out-of-scope and cannot be sourced by the Reference Guardians.
For websites when the PDF is provided by agency, accessed date for the website PDF should not be older than 6 months.
Abstracts, if not available through InsightMeme, the agency will have to provide the necessary PDF.

Are there multiple requests for references?

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Multiple Requests for References??

Please enter multiple requests on the excel sheet [LINK] and upload into the "File Upload" section below. File must be a .xlsx format. If there are multiple requests for other types, one excel form can be used.

Literature Reference (Author Name, Title, Journal Name, Year, Volume Number/Issue Number, Inclusive Page Number, DOI)*

Please enter the reference request in the "AMA" style. Example: Rangachari D, Yamaguchi N, VanderLaan PA, et al. Brain metastases in patients with EGFR-mutated or ALK-rearranged non-small-cell lung cancers. Lung Cancer. 2015;88(1):108-111

Prescribing Information - Use this for single request