Date: {{$ActivityAssignDate}}

To,


Sun Pharma Industries Ltd,

Sun House, Goregaon East

Mumbai


Subject: : To obtain clinical insights and understanding place of Tofacitnib in Rheumatoid arthritis management


In response to your letter dated _________, I agree to participate in the study as outlined by you.


I understand that:


  • You will provide me with a copy of the survey questionnaire

  • The patient’s identity will not be disclosed in the survey form.


My personal details are given below for accuracy of your records.
Name: {{$doctorName}}
Qualifications:
Specialty
Postal Address:
PIN Code :
Clinic or hospital telephone No
Residence telephone No

Yours sincerely,

[Signature]
{{$doctorName}}