NPI Number and office or hospital name where you practice are required to send product samples to patients. 

Click here if you want to update your account with your NPI and then return to this page to complete the sample request. If you do not have an NPI number, a colleague within your organization who has an NPI number can grant you access through their account page on Pediatric ProConnect.

If your hospital or office is not listed, please click here to request an appointment with a Sales Representative to gain access to product samples for your patients.

You have reached the sample request limit,  Click here to contact your sales representative.

You must be logged in and have an NPI number associated with your account to request samples.