Before you complete this form 1. Understand cases what we can and cannot investigate. 2. Be clear on what you are reporting and provide as much information as possible to enable further consideration by the Ethiopian Pharmaceuticals Supply Service. 3. Understand the protections that Ethiopian government apply to persons making complaints. This form is secured to protect your privacy and more details on alternative ways to contact us are available here. Email; mulusew.ayalneh@epsa.gov.et, melesse85@gmail.com Mobile; +251- 943516001 In person; Office of Ethiopian Pharmaceuticals Agency Ethics Liaison Directorate Fields with an asterisk * are mandatory fields.