Request samples for qualified clinics. Submissions create or update your practitioner profile for fulfillment and support
Request Samples
One sample box per approved practitioner. Samples are available for qualified clinics only.After you submit the form, you’ll receive an email confirmation. Our team reviews requests and ships to the clinic address provided or on file. If we need additional verification, we’ll contact you by email.or ordering questions or document access issues, use Contact support.
Form fields (recommended): Clinic name; practitioner name; professional credential; specialty; license/NPI; email; phone; shipping address; SKU requested; intended use; approximate # of patients.