Event Sample Request

Welcome to the Biofreeze Professional Events Sampling Page

ALERT: Due to the Coronavirus outbreak we have temporarily suspended the Biofreeze sample program.

The samples will be available once again when we resume normal business after the pandemic has ended.

Thank you for your understanding.

To request your Event Samples, please complete the information below:

Please Note: Requests for event samples must be received 10 WEEKS PRIOR to your requested delivery date. If you have not allowed at least 10 weeks, the request WILL NOT be processed.

Samples are only available to healthcare professionals who sell Biofreeze. If your request is approved you will receive the samples by the “needed by” date provided.

Please complete form in full or the request will not be processed.

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Contact Information

First Name

Last Name

Title

Discipline

Practice Information

Practice Name

This will be printed on the customized cards.

Shipping Address

Please use a physical address as we will not ship to PO Boxes.

Suite / Unit #

City

State

Note: We do not currently ship samples to Alaska or Hawaii.

Zip

Text

Phone

Please follow the format 000-000-0000. This will be printed on the customized cards.

Retail Information

From What Main Distributor Do You Purchase Biofreeze Professional?

If you sell Biofreeze this question MUST be answered with the name of an authorized distributor.

Do you sell Biofreeze Professional?

Yes

Event Date

Event Start Date - Month

Event Start Date - Day

Event Samples

Event Name

Participants Expected

Samples Needed By - Month

Samples Needed By - Day

Number of samples requested

Maximum of 250

Is there a registration bag?

Yes

Will samples be put in the registration bag?

Yes

Coordinator Information

Comments