Product Samples Order Form


Welcome to the Biofreeze® Build Your Practice Sign-Up page. 
 
Biofreeze has a unique sampling program to drive new patients/clients to your practice. We are happy to provide 100 customized Biofreeze samples per month absolutely free! We’ll even print your practice name and phone number or address on the sample card. Give them out at runs, community health fairs, or other local events to promote your practice. Order your samples online every month, hand them out, and watch your sales grow and gain new patients/clients!
 
( If you need samples for an event, CLICK HERE to access the Event Samples Order Form. )
 
To receive your complimentary customized marketing materials, please complete the information below.
 
 
 
Required fields are in red.
Contact Information:
First Name:
Last Name:
Title:
Email:
Discipline:
 
Practice Information:
Practice Name: (This field will be used for "Customized" printing orders.)
Shipping Address: (No P.O. Boxes.)
Suite / Unit #:
City:
State:
Zip:
Phone: (This field will be used for "Customized" printing orders)  
Fax:    
Website:
Patients Per Month:
Practitioners on Staff:
 
Retail Information:
Do You Sell Biofreeze?:
Your MAIN Distributor:
 
Do you need marketing material for your practice, then fill out this section.
If you need samples for an event, then you should use the Event Marketing Form.
Marketing Support:
 
SAMPLE CARDS
Customized with sample [Preview]
Customized with sample [Preview]
IN CLINIC MARKETING
Countertop Display [Preview]
Window Cling/Decal [Preview]
TRAINING AND EDUCATION
Massage Manual [Preview]
Patient Education Video [Preview]
 
Comment:
 
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