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Product Sample Request

Product samples are available for any and all MassHealth Approved members. To request a sample, simply enter in your information and the products in which you wish to sample below, and a member of our team will reach out to help facilitate the products being sent directly to the address provide below.


If you have any questions, please feel free to give us a call at 1-800-442-1205 or by email at

Name of Account *

Email Address *

Recipient Attn

Product # Requested

QTY (EA) Needed

Thanks! Message sent.

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