Date: {{$ActivityAssignDate}}

To,


Mr. Sunil Jajoo


VP & Cluster Head, Dermatology

Sun Pharmaceutical Industries Ltd.


Dear Mr. Sunil Jajoo,


Subject: Drug utilization pattern in alopecia


In response to your letter dated _________, I agree to participate in the drug utilization study as outlined by you. I understand that:


  • You will provide me with a copy of the study plan, ___ data collection form (DCF)

  • The patients’ identity will not be disclosed in the DCF

My personal details are given below for accuracy of your records.

Name: {{$doctorName}}
Qualifications:
Speciality:
Postal Address:
Pin Code:
Clinic/Hospital Tel. No.:
Residence telephone No.

Yours sincerely,


[Signature & Stamp]


{{$doctorName}}