You are here Home Guidance and resources Resources Forms Report a perceived breach or questionable practices Use this form to report a perceived breach of the Therapeutic Goods Act, counterfeit products or questionable practices in relation to therapeutic products. Listen Print Share LinkedIn Twitter Facebook Email Loading... If you have a query about therapeutic products in general, please see: Contact the TGA where you will find contact details for specific enquiries. If you want to report an adverse reaction to a medicine or a medicine deficiency or defect, please see: Reporting medicine problems. If you want to report an adverse event with a medical device, please see: Reporting medical device problems. If you want to report non-compliant advertising, please see: Reporting a non-compliant advertisement. For general privacy information, please see: Privacy. Form This form should ONLY be used to report a perceived breach of the Therapeutic Goods Act or to report questionable practices in relation to therapeutic products. For example: someone supplying an unapproved therapeutic product, questionable manufacturing practices, etc. Your contact details Your contact details Your contact details Provide You can provide a pseudonym or remain anonymous, but it can help an investigation if we can contact you later to ask for more information. If you do provide your name and contact details, we will take all practical measures to protect your identity. The information you provide may be used for sharing with law enforcement and government agencies, criminal investigations and/or in legal proceedings. Personal information is protected under the Privacy Act 1988. For more information, see Privacy. Your name Your email address Your telephone number Your mobile phone number Your fax number Details of problem Details of problem Date problem was encountered (mandatory) Name of product of concern (mandatory) AUST R or AUST L number on product label, if known Name of company/person supplying the product Address of company/person, if known Contact details of company/person, if known (telephone, fax, website, etc.) Details of problem - please be as specific as possible (mandatory) Do you have a sample of the product or any other supporting material? Yes No Leave this field blank