Sample Release Canadian English – Vitamin Ddrops Forms

* Clinic/Practice Name

* Email Address

Salutation

* Healthcare Practitioner Name

* Clinic/Practice Address (No residential addresses)

Suite

* City

* Country

* Province/Territory

* Postal Code

* Business Phone

Fax

Practice Information

* Name of Contact on Staff

* Number of Healthcare Providers at your office

* Number of first time newborn visits seen per

* Delivery Hours (Days and Times)

Lunch Closures (Times)

Additional Comments

Order Information

Baby 400 IU Vitamin D3 Drops
(15 dose bottle) Baby (0 months+)

Daily recommended 400 IU of Vitamin D3 to support healthy growth and development in just one drop^† No large volume syringes or eyedroppers 400IUSelect Kids 600 IU Vitamin D3 Drops
(15 dose bottle) Children (1 year+)

Daily recommended 600 IU of Vitamin D3 to support healthy bones, teeth and immune function in just one drop^† No sugary gummies or chewables. 600IUSelect Adult 1000 IU Vitamin D3 Drops
(15 dose bottle) Adults

Daily recommended 1000 IU of Vitamin D3 to support healthy bones, teeth and immune function in just one drop^† No large capsules or tablets. 1000IUSelect Adult 2500 IU Vitamin D3 Drops
(15 dose bottle) Adults

Extra strength 2500 IU of Vitamin D3 to support healthy bones, teeth and immune function in just one drop^† No large capsules or tablets. 2500IUSelect

Resources for you & your patients

Vitamin D3

Vitamin D Brochures English with couponVitamin D Brochures French with couponBrochure Holders

Probiotic Resources

Probiotic Brochures English with couponProbiotic Brochures French with couponProbiotic Clinical Summary EnglishProbiotic Clinical Summary French

DHA Omega-3 Resources

Thinkmist DHA Brochures English with couponThinkmist DHA Brochures French with couponBrochure Holders

*By checking the box and submitting this form I AGREE to:

Terms & Privacy Policy: I have read and agree to privacy policy and terms on the Ddrops website prior to submitting this sample request form.

Contact Terms: 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 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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