This form is used to inform ZTAS of changes to details of patients registered with the ZTAS. For the safety of patients treated with
Zaponex® (clozapine) and to ensure an adequate and efficient monitoring service, it is necessary that the ZTAS database be properly
maintained.
We will use the information provided on this form in accordance with the terms of the ZTAS privacy notice which is available from the
ZTAS website www.ztas.co.uk.