If you are a doctor, a nurse, a midwife or a  physiotherapist, please use the form below to submit your request for GYNACAN product samples (30 Vegicaps format) and/or patient information.

Samples are only intended for the above mentioned health care professionals for their patients and will not be sent to retail pharmacies. Samples are also not intended for resale.

Please note that we require your medical licence number to confirm the validity of your request.

We value your privacy. All information you provide will be kept strictly confidential.