Information Request Form

Section:	Main.A1. CORP. INDEX. A-Am No. 1.Adolor/P C2.1998. 03.16.1998. Analgesia
Code:	28860
Product:	USA. A
Company or Organization:
Contact's name *:
Position:
E-mail:
Mailing address:
Phone number:
Fax number:
Fields of interest:	CLINICAL STUDY ADDRESS FAX NUMBER PATENT NUMBER
* If you are not linked to any company or organization complete at least this field