Material Transaction Notice

Welcome!

Welcome to the material transaction notice submission form. Please read through
the instructional pages before beginning the form.

The Department strongly encourages Parties to download
the pdf of all form questions ahead of time through this link.

A copy of these instructions can be found on the cover page linked here.
Keep this copy open for reference as you complete the form.

Form Instructions:

Use this form to submit a Material Transaction notice to the Department of
Health. Here are some guidelines for filling out the form:

• You need to fill out all fields of the form. You can select “not
applicable” as needed. For numerical fields enter "999" if not applicable.
• You can save your progress by clicking on the save button and
adding your email address. You will receive a unique link to your
form by email from noreply@alchemer.com (please check your
spam/junk folder if you don’t see it). Use this feature to return to the
form later.
• The unique link can be shared with other Parties as needed to
complete portions of the form.
• For each required document upload, you can attach up to 10 files.
Each file can be up to 50 megabytes (MB). The following file formats
are accepted: png, gif, jpg, jpeg, doc, xls, docx, xlsx, pdf, txt, mov, mp3,
mp4.