You are - Select -IndividualDoctor/health professionalPharmacistI live outside mainland FranceOther Speciality Subject - Select -Information about a productRequest for documentationAccess reserved for healthcare professionalsOther questions Civility Mr Mrs/Ms Civility Dr Surname First name Email Address 1 Address 2 Post code Town/City Country Are you already a PiLeJe customer? Yes No If you are, please enter your customer reference How did you hear about PiLeJe? Message Send my request The information collected via this form shall be used by PiLeJe, which is responsible for handling this data, to process your request and to manage our dealings with you.In accordance with French law No. 78-17 of 6 January 1978 (amended) and with EU General Data Protection Regulation 2016/679 of 27 April 2016, you can exercise the right to access, rectify, restrict or remove data about you or assert your right to data portability. To exercise these rights, send a letter, enclosing proof of identity, to PILEJE – DPO – 1 ZI du Taillis – Champtoceaux – 49270 Orée d’Anjou, France or email DPO@pileje.com.For more information about how we manage your personal data.* These fields must be completed to enable us to process your application. We cannot proceed without this information. Leave this field blank
