Request Samples

If you are a nurse, a midwife or a naturopath, please use the form below to submit your request for product samples and/or patient  information. Physicians are kindly asked to order samples through Physicians Online.

Samples are only intended for the above mentioned health care professionals for their patients and will not be sent to retail pharmacies. Samples are also not intended for resale.

Please note that we require your medical licence number to confirm the validity of your request.

We value your privacy. All  information you provide will be kept strictly confidential.

Fields marked with * are required

Please enter your province