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Sample Request Form

Which product would you like a sample of?


PLEASE NOTE: Samples will only be sent out to individuals who have a medical license or work at a facility that has one. There are a limited amount of samples that can be distributed. Requester is to pay all shipping & handling costs. Shipping samples are at VORTRAN's discretion and handled on a case-by-case basis. Not all sample requests are guaranteed.

Thanks for submitting!

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