IVD WHO PQ QUOTE REQUEST FORMPlease enable JavaScript in your browser to complete this form.1. IMPORTANT INFORMATION - Step 1 of 6 You must fill in the requested details to receive a precise WHO PQ Service Proposal. Based on the information entered online, we will determine the price and timeline. We understand that this process may be challenging, especially for startup business owners and manufacturers, but providing accurate details is essential for us to serve and support you better Please remember to complete separate QRF form for each IVD you intend to apply for WHO PQ.NEXTLegal Manufacturer Name *Manufacturers looking to supply IVDs to WHO procurement agencies, UN organizations (UNICEF, UNDP, etc.), and global health programs only need to fill the formAddress *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryWebsite / URLBACKNEXTScope of Manufacturer *SelectDesign, Manufacture and Sale of DeviceManufacturer and Sale of DeviceScope of I3CGLOBAL *SelectWHO PQ Full Assessment SupportWHO PQ Abridged Assessment SupportThe abridged assessment option is available only for products that have already CE, TGA, FDA Approved.Product Expert *Currently we do not have a product expert to work with consultant teamYes, we have product technical expert to provide device information to consultant teamWill appoint if required.ISO 13485 / QMS expert *Currently we do not have QMS / 13485 expert in our organizationYes, we have QMS/13485 documentation expert.Will appoint if required.BACKNEXTIVD Device Category *SelectHIV DiagnosticsTuberculosis (TB) DiagnosticsMalaria DiagnosticsHepatitis B & C DiagnosticsHuman Papillomavirus (HPV) DiagnosticsCOVID-19 & Other Respiratory InfectionsSexually Transmitted Infections (STI) DiagnosticsBlood Safety Screening Tests (e.g., HIV, HBV, HCV in blood donations)Ebola and other outbreak-prone disease diagnosticsOthersSpecify Device BACKNEXTIs the IVD Approved by any of the below Authorities *SelectYes, CE CertifiedYes, USFDA ApprovedYes, Health Canada ApprovedYes, TGA Australia ApprovedYes, Labour and Welfare Japan ApprovedNoIs the Device Packed with ConsumablesYesNoBACKNEXTSubmitter Name *Designation / Job Title *Phone *Email *BACKSubmit