We welcome your inquiry to explore alliances with Astellas, particularly in our
focused areas of interest. To submit your request, please fill out the form below.
If you would like, we encourage you to attach a detailed, non-confidential package
that includes data on mechanism of action, as well as any supporting scientific
findings.
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Astellas Licensing or Alliance Inquiry Form
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*Required Fields
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Company Information
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Organization Name*
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Organization Website
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Country*
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Business Address 1*
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Business Address 2
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Business City
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Business State
Business Province
*
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Postal Code*
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Contact Information
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First Name*
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Last Name*
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E-mail address*
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Phone*
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Fax
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Opportunity Information
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Please submit only one opportunity for each Licensing or Alliance Inquiry.
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Opportunity Name
*
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(Maximum characters: 50)
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Opportunity Type*
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Current Development Phase
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Therapeutic Area*
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Primary Indication
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Secondary Indication
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Deal Type
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Brand Name
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Mechanism of Action
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500
characters remaining Max: (500 characters)
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Opportunity Description
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500
characters remaining Max: (500 characters)
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Current Patent Status
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Expected Launch Date
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Patent Expiry
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Territory
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Add Attachment(s):
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(Non-confidential documents only)
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Procedures for Submission of Information:
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I have read the above Procedures for Submission of Information and:
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