Use of your NPI number
Your NPI number lets us determine which samples are available for you and allows us to verify that you’re authorized to write prescriptions.
Use of your email address
Sample Center uses your email address only for the following purposes:
- Providing confirmation that you have successfully activated your account
- Providing confirmation that you have successfully placed a sample request
- Notifying you when new samples are available
Your email address and associated information will not be used for any purpose other than providing this service to you.
Discontinue your participation
You may de-activate your account at any time by emailing us at firstname.lastname@example.org or by calling our toll-free customer support hotline at (866) 363-3726.
Records of previous sample Requests
The Sample Request History link provides an easy way to review your previous transactions.
- If you wish to reprint a request form, click the request number and click Reprint Fax
- If you are resending a request (not requesting again), the requesting physician must sign the request summary document and fax it to the number printed at the bottom of the form