Date: {{$ActivityAssignDate}}

To,


Mr. Sandeep Sharma,
Associate Vice President


Sun Pharma Laboratories Limited,

Sun House, Plot No. 201,B/1,
Western Express Highway,
Goregaon (E), Mumbai 400063


Subject : To understand real world insights in glaucoma among ophthalmologists for usage on Netarsudil


In response to your letter dated 1st May,2023 I agree to participate in the survey as outlined by you.
I understand that:


  • You will provide me with the copy of a questionnaire which will have multiple choice questions

  • The questions would be answered based on my clinical experience & routine practice

  • No patient identity will be disclosed during the feedbacks


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

Name: {{$doctorName}}
Qualifications:
Specialty :
Postal Address:
Clinic/Hospital Tel. No.:
Residence/Mobile No. :






Yours sincerely,

[Signature & Stamp]
{{$doctorName}}