Your Voice - for Medical / Pharmaceutical Professionals

Please fill in all the fields of this form and click on the button to confirm content.

First name
Family name
Name of hospital/facility
Department
Profession
E-mail address
Telephone
City
Country

Asahi products currently used

Your experiences, opinions, and feelings when using our products

Purpose for using personal information

The purpose of using personal information provided to us is, in principle, only to respond to inquiries, to provide information related to products and services of Asahi Kasei Corp. and its affiliates (hereinafter the Asahi Kasei Group), and to improve products and services of the Asahi Kasei Group. In the case of other purposes, we provide advance notice to you at the time you provide personal information to us. We will not use your personal information other than for such appropriate purposes described above without your permission. Please read our Privacy Policy before sending your inquiry to us.

If you accept the purpose for using personal information and Privacy Policy, check the box below.

I accept.