Recipe Submission

Fill in the form below to tell us about your recipe idea. With your permission, we may wish to contact you to confirm details of your recipe. Please note, your recipe will not be published without your prior permission and you may choose to remain anonymous.

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First name: *
Surname: *
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Enter your recipe here: *
   

We would like to understand whether you suffer from abdominal pain, cramps or discomfort and how this condition affects you. Please take a minute to complete the information below.

Do you ever suffer from abdominal pain/cramps or abdominal discomfort? *
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Once a week More than once a week
Once a month Two or three times a month
Once a year Two or three times a year
How severe would you rate the abdominal pain/cramps or abdominal discomfort you suffer from? *
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Do you think the abdominal pain/cramps or abdominal discomfort you suffer from is due to IBS? *
Yes No Don't know

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We may use the information you have provided to update you on, or to seek your opinion on, our products from time to time. This information will not be passed to any third party. If you would prefer us not to contact you for these purposes please untick the box.

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Boehringer Ingelheim Limited
Ellesfield Avenue
Bracknell
Berkshire
RG12 8YS
United Kingdom

Phone: +44 (0)1344 741 186
Fax: +44 (0)1344 741 399

Company Registration: 0711858 (England & Wales)
V.A.T. No.: 200 3561 26 GB
e-mail address for contact:
communications@bra.boehringer-ingelheim.com

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