Voluntary Adverse Event Reporting via the SRP (other than RFR reports)

FDA Adverse Event and Products Experience Reports; Electronic Submissions

0645 IC 1 CTP Wireframe TPRv2

Voluntary Adverse Event Reporting via the SRP (other than RFR reports)

OMB: 0910-0645

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Tobacco Product Report v2 Wireframes
December 2015

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My Reports - TPR

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My Account -TPR

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Introduction - TPR

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Contact Information - TPR

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Problem Summary

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What are the main symptoms or health problems?

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Tobacco Products

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Tobacco Product Details

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Tobacco Product Part Details

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Other Tobacco Products Used

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Other Tobacco Products Used Details

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Additional Information

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Attachments

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Attach File

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