Download reporting forms and promotional material for the Yellow Card Scheme

Forms
Reporting forms can be downloaded here, so that you can fill them in and return them by post if you do not wish to use the online reporting site for the Yellow Card Scheme (opens in new window)

Patient reporting form (1022Kb)

Healthcare professional reporting form (89Kb)

Completed forms should be sent to:

FREEPOST YELLOW CARD

Guidance notes to accompany the patient reporting forms are available in the leaflet below.  These include information on what to report and how to complete the form:

Leaflet on what to report and how to complete the patient reporting form (384Kb)

Promotional material
The MHRA is running a public awareness campaign during late February - March 2008 in community pharmacies to promote the Yellow Card Scheme and ensure that patients and members of the public know that they can report possible side effects of medicines they are taking to the MHRA.

The poster and patient information card developed by the MHRA for the campaign can be freely downloaded here:

Promotional poster for Yellow Card Scheme (1368Kb)

Patient information card (470Kb)

The leaflet on patient reporting distributed to community pharmacists during the promotional campaign is also available below.  This is intended to provide a brief guide on patient reporting for healthcare professionals.

Patient reporting leaflet - a brief guide on patient reporting for healthcare professionals (66Kb)

 

Guidance and further information

Healthcare Professional Guidance to Reporting (135Kb)

Healthcare Professional Information Card (421Kb)

Yellow Card Information Presentation (331Kb)

Member of Public Information Card (Welsh) (50Kb)

Yellow Card Poster (Welsh) (88Kb)