Individual Pharmacy Claim Form: Nicovape® Q A1 Device & Q | Q SD Nicotine Cartridge SKUs

Immediate Actions Required:

• Cease Sale and Dispensing: Effective from January 14th, 2025, cease all sales and dispensing of the listed SKUs. Please remove all affected products from your shelves immediately.
• Inventory Check: Conduct a thorough inventory check to identify all stock of the affected SKUs.
• Submit Stock Details: Use the form below to submit the details of your remaining stock. Include quantity for each SKU, Pharmaceutical Wholesaler Ethicals Acc Number, Wholesale Invoice Number and relevant contact details.

Compensation for Compliance:

• Product Replacement: Through your wholesaler, Liber Pharmaceuticals will replace the discontinued products by issuing a turnover order to your pharmacy with compliant stock that equals the same value and reconciles against the credit applied to the discontinued stock.
• Destruction and Handling: All affected Nicovape Q | Q SD Nicotine Cartridges can be disposed of via your pharmacy’s RUM bin.
  (N.B. Some vaping products, including cartridges, replacement pods and liquid nicotine from reusable vapes can be put into the RUM bin. But single-use vapes (with enclosed lithium batteries) must NOT be put into the RUM bin and are not accepted by landfills or your domestic rubbish collection.)

Please complete the following form to submit your stock details and to acknowledge the receipt of this notice:

Please ensure all details are completed to facilitate internal approval and processing of your claim.