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Sample Release Order Form
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Practice Information
* Clinic/Practice Name
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Canada
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Order Type:
New
Renew
Please Specify:
Vitamin D
Baby Ddrops
®
400 IU Samples (15 dose bottle)
Ddrops
®
Booster 600 IU Samples (15 dose bottle)
Ddrops
®
1000 IU Samples (15 dose bottle)
Vitamin D Brochures English
Vitamin D Brochures French
Brochure Holder
DHA Omega-3
Thinkmist
TM
DHA Brochures English
Brochure Holder
Symptom Relief
Coldrops
®
Samples (15 drop bottle) - Adult symptom relief
Kids Coldrops
®
Samples (15 drop bottle) - Children 5 - 12 years
Coldrops
®
Brochures English
Coldrops
®
Brochures French
Brochure Holder
* I AGREE, I have read and agree to the privacy policy and terms on the Ddrops website prior to submitting this sample request form.
* By checking the box and submitting this form I consent to receiving informational, promotional and other marketing material from Ddrops Company at the facsimile number, telephone number(s) and email address(es) provided above on an ongoing basis unless and until I withdraw my consent. The contact information I have provided is my contact information as an individual healthcare provider, and is not that of an emergency line, or healthcare facility.
You have the option of modifying or discontinuing the samples program and/or the marketing promotions program at any time. You may contact Ddrops Company at
healthcare@vitaminddrops.com
or 1-844-433-7677 or by mail at 126 Trowers Road, Woodbridge, Ontario, Canada, L4L 5Z4.
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