Request
Product Samples

Physicians may order patient samples for their offices. Please order online by completing the information below.

Note: We do not automatically send out samples on a regular basis. Please reorder as needed.

Office Hours:
Monday - Friday, 8 am - 5 pm CT
1-800-325-8232 or 507-288-8500
Fax: 507-288-7603

PSI is dedicated to developing specialized skin care products for the needs of physicians and their patients. Thank you for recommending our products.

Have you received samples from us before? Yes No
Customer ID: Medical Specialty (Required):
License Number (Required): Name (Required):
Title (Required): Clinic/Practice Name (Required):
Ordered By (Required): Daytime Phone (Required):
Fax Number: Email Address:
If you want samples sent to more than one office, please fill in address information for each office:
Office 1
Street:
Suite/Bldg:
City:
State:
Zip Code:
Country:
Phone:
Office 2
Street:
Suite/Bldg:
City:
State:
Zip Code:
Country:
Phone:
Office 3
Street:
Suite/Bldg:
City:
State:
Zip Code:
Country:
Phone:
 
Mailing Address (if different than Office Address):
Street: City: Country:
State: Zip Code:    
 
How did you find out about our products:
Advertising Magazine Pharmacist Mailing Trade Show Colleague
 
Please send samples of the following products:
Free & Clear™
RoBathol™
Vanicream™
Vanicream™ Sunscreen
Vaniply™
Shampoo
Conditioner
Bath Oil
Skin Cream
Lite Lotion
Cleansing Bar
SPF 30
SPF 60
SPF 35 Sport
Ointment
* Free & Clear™ Hair Sprays, Vanicream™ Lip Protectant, and Vitec™ Vitamin E Lotion samples are not available.
Free & Clear™ Hair Gel, Free & Clear™ Liquid Cleanser and Vanicream™ Shave Cream samples are available by contacting our customer service dept.
 
Questions or Comments?
 
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Pharmaceutical Specialties, Inc. is a BBB Accredited Business. Click for the BBB Business Review of this Pharmaceutical Products - Wholesale & Manufacturing in Rochester MN Pharmaceutical Specialties, Inc. was voted a Top Workplace by StarTribune for 2011

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Free & Clear, RoBathol, Vanicream, Vaniply and Vitec are trademarks, or registered trademarks, of Pharmaceutical Specialties, Inc. in the US or other countries. Made in the USA.