Request Patient Samples


Healthcare professionals can order Dermalex samples and product information for their patients. Simply fill out the form below. We do not automatically send out Dermalex samples on a regular basis. Please reorder as needed. Information provided will be kept strictly confidential.



First Name
Last Name
Practice Name
Postal Address
Email Address
Additional Information
I agree to the Terms and Conditions

1. We reserve the right to collect information to be used for a mailing database. 2. Samples available to Australian healthcare professionals only. 3. Product samples will arrive in approximately 2 - 4 weeks. 6. No responsibility will be taken for product samples once they have been posted. 7. Samples available only whilst stocks last.


Always read the label and use only as directed. If symptoms persist, see your healthcare professional


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