Event Request Form

The trial sized samples are available in the Original Warm Therapy and the Newer Cool Therapy and are offered at no charge for event purposes to certified health professionals only.  Please fill out this form in full and submit it at least four (4) weeks prior to the date of the event. Submit a copy of the schedule or event program along with this form using the Attach File button. Quantities sent may vary from quantities requested. We will only ship to addresses in the United States.

Please do not submit sample request more then 90 days prior to date that you need samples delivered.

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