IQVIA Data Submission Request Form

Thank you for contacting IQVIA about your willingness to participate in our database. To be considered for our review process, please complete this form and email using the submit button below.

Your Business Information

Please individually list the NCPDP#(s) for each store you wish to participate in our database.

What is the name of the software vendor you utilize? (i.e., name of pharmacy terminal computer company supporting your store’s pharmacy platform)

Do you use multiple software vendors? (If yes, please list the names of the different vendors you use and what business segment they support.)

Who referred you to IQVIA? (Please state the full name of the source and the name of the company they represent.)

Please provide any additional information impacting your request to participate in our database

By submitting this form you agree to our Terms of Use and Privacy Policy. Information provided by you may be collected and automatically stored in our database and may be used for sending you additional information about IQVIA and our services. Such information also may be transferred to IQVIA companies in other countries. Copyright © 2018-2022 IQVIA Holdings Inc. and its affiliates. All rights reserved.
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