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Request Samples

15 ml EN smallIf you are a doctor or a nurse practitioner, please use the form below to submit your request for Gynatrof product samples (15 ml format) and/or patient  information.

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

Samples are only intended for clinical evaluation by physicians or nurse practitioners for their patients and will not be sent to retail pharmacies.

Samples are also not intended for resale.

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

I would like to receive patient samples
I would like to receive patient materials
I confirm that I am a licensed medical professional or an official representative of the medical practice.