Letter of Authorization Form

To request an Letter of Authorization (LOA), please complete West’s on-line LOA request form. Entering your Email below and clicking NEXT will allow you to access the form. Once you have entered all information (required information is denoted by an *), click Submit. After a successful submission, a confirmation Email will be sent to your attention.

English is required for FDA and Health Canada LOAs.  For assistance locating your West item number, click here.

If you have any issues or questions, please contact Exton.LOArequests@westpharma.com

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