< Back to Sample Homepage Please do not use this form in a clinical emergency. For Republic or Ireland, please use this sample request form To speak to a member of our customer services team, please email uksamples@vitaflo.co.uk or call 0151 702 4936. These samples are for... - Select -Disorders of Protein Metabolism Disorders of Fat MetabolismGlycogen Storage DiseaseDrug Resistant Epilepsy (DRE)Paediatric Kidney DiseaseAdult Kidney Disease Please select which disorder: - None -PKUMSUDHCUTYRMMA/PAGAIVAUCD Please select which disorder: - Select -Long Chain Fatty Acid Oxidation DisorderMedium chain Acyl-CoA Dehydrogenase Deficiency Please select your samples Please select your samples I want to order Lipistart This is necessary to ensure we are following IFSMP regulations. Lipistart Lipistart - 1x400g Long Chain Fatty Acid Oxidation Disorder MCTprocal - 30x16g Medium chain Acyl-CoA Dehydrogenase Deficiency SOS 10 - 30x21gSOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Glycogen Storage Disease Glycosade Lemon - 30x60g Glycosade Unflavoured - 30x60g Drug Resistant Epilepsy (DRE) Fruitivits - 30x6g K.Flo - 24x250mlK.Quik - 15x225mlK.Yo Chocolate - 36x100gK.Yo Vanilla - 36x100gK.Vita - 30x120mlMCTprocal - 30x16g I want to order Renastart This is necessary to ensure we are following IFSMP regulations. Renastart Renastart - 1x400g Paediatric Kidney Disease Renastep - 24x125mlVitajoule - 1x500g Adult Kidney Disease Renastep - 24x125mlVitajoule - 1x500g I want to order PKU start, squeezie or explore This is necessary to ensure we are following IFSMP regulations. PKU start, explore and squeezie PKU start - 4x400g PKU explore 5 Unflavoured - 30x12.5g PKU explore 10 Raspberry - 30x25gPKU explore 10 Orange - 30x25g PKU squeezie Apple & Banana - 30x85g PKU cooler, air, express plus, sphere and motion PKU cooler 10 Orange - 30x87ml PKU cooler 10 Purple - 30x87ml PKU cooler 10 Red - 30x87ml PKU cooler 10 White - 30x87ml PKU cooler 10 Yellow - 30x87ml PKU cooler 15 Orange - 30x130ml PKU cooler 15 Purple - 30x130ml PKU cooler 15 Red - 30x130ml PKU cooler 15 White - 30x130ml PKU cooler 15 Yellow - 30x130ml PKU cooler 20 Orange - 30x174ml PKU cooler 20 Purple - 30x174ml PKU cooler 20 Red - 30x174ml PKU cooler 20 White - 30x174ml PKU cooler 20 Yellow - 30x174ml PKU air 15 Gold - 30x130ml PKU air 15 Green - 30x130ml PKU air 15 Red - 30x130ml PKU air 15 White - 30x130ml PKU air 15 Yellow - 30x130ml PKU air 20 Gold - 30x174ml PKU air 20 Green - 30x174ml PKU air 20 Red - 30x174ml PKU air 20 White - 30x174ml PKU air 20 Yellow - 30x174ml PKU express Plus 15 Lemon - 30x25g PKU express Plus 15 Orange - 30x25g PKU express Plus 15 Tropical - 30x25g PKU express Plus 15 Unflavoured - 30x25g PKU express Plus 20 Lemon - 30x34g PKU express Plus 20 Orange - 30x34g PKU express Plus 20 Tropical - 30x34g PKU express Plus 20 Unflavoured - 30x34g PKU sphere 15 Chocolate - 30x27g PKU sphere 15 Red Berry - 30x27g PKU sphere 15 Vanilla - 30x27g PKU sphere 20 Banana - 30x35g PKU sphere 20 Chocolate - 30x35g PKU sphere 20 Lemon - 30x35g PKU sphere 20 Red Berry - 30x35g PKU sphere 20 Vanilla - 30x35g PKU sphere 20 Liquid - 15x237ml PKU sphere 20 Liquid Chocolate - 15x237ml Mevalia PKU Motion 10 Red Fruit - 30x70ml Mevalia PKU Motion 10 Tropical - 30x70ml Mevalia PKU Motion 20 Red Fruit - 30x70ml Mevalia PKU Motion 20 Tropical - 30x70ml PKU Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Valine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. I want to order MSUD explore This is necessary to ensure we are following IFSMP regulations. MSUD explore MSUD explore 5 Unflavoured - 30x12.5g MSUD cooler, express and amino5 MSUD cooler 10 Red - 30x87ml MSUD cooler 15 Orange - 30x130ml MSUD cooler 15 Red - 30x130ml MSUD cooler 20 Red - 30x174ml MSUD express 15 - 30x25g MSUD express 20 - 30x34g MSUD amino5 - 30x6g MSUD Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Valine 50 - 30x4g Tyrosine 1000 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. I want to order HCU explore This is necessary to ensure we are following IFSMP regulations. HCU explore HCU explore 5 - 30x12.5g HCU cooler and express HCU cooler 10 Red - 30x87ml HCU cooler 15 Orange - 30x130ml HCU cooler 15 Red - 30x130ml HCU cooler 20 Red - 30x174ml HCU express 15 - 30x25g HCU express 20 - 30x34g HCU Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Valine 50 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. I want to order TYR explore This is necessary to ensure we are following IFSMP regulations. TYR explore TYR explore 5 - 30x12.5g TYR cooler, express and sphere TYR cooler 10 Red - 30x87ml TYR cooler 15 Orange - 30x130ml TYR cooler 15 Red - 30x130ml TYR cooler 20 Red - 30x174ml TYR express 15 - 30x25g TYR express 20 - 30x34g TYR sphere 20 Red Berry - 30x35gTYR sphere 20 Vanilla - 30x35g TYR Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Valine 50 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. I want to order MMA/PA explore This is necessary to ensure we are following IFSMP regulations. MMA/PA explore MMA/PA explore 5 - 30x12.5g MMA/PA cooler, express and amino5 MMA/PA cooler 15 Red - 30x130ml MMA/PA express 15 - 30x25g MMA/PA amino5 - 30x6g MMA/PA Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. I want to order GA explore This is necessary to ensure we are following IFSMP regulations. GA explore GA explore 5 - 30x12.5g GA amino5 GA amino5 - 30x6g GA Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Valine 50 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Vitajoule - 1x500g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. IVA Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Valine 50 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43g Doc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. UCD amino5 and EAA Supplement UCD amino5 - 30x6.6g EAA Supplement - 30x12.5g UCD Support Products Cystine 500 - 30x4g Isoleucine 50 - 30x4g Leucine 100 - 30x4g Tyrosine 1000 - 30x4g Valine 50 - 30x4g Phenylalanine 50 - 30x4g Fruitivits - 30x6g Basecal 200 - 30x43gDoc Omega - 30x4g Key Omega - 30x4g Flavourpac Blackcurrant - 30x4g Flavourpac Orange - 30x4g Flavourpac Raspberry - 30x4g Flavourpac Tropical - 30x4g SOS 10 - 30x21g SOS 15 - 30x31g SOS 20 - 30x42g SOS 25 - 30x52g Single Dose Amino Acids, Basecal, Key Omega, Doc Omega, Flavourpac and SOS. Low Protein Foods Vitabite - 7x25g ProZero Neutral - 6x1L ProZero Neutral - 18x250ml ProZero Chocolate - 18x250ml Mini Crackers - 15x40g Fate All Purpose Mix - 1x500g Fate Cake Mix - 2x250g Fate Chocolate Cake Mix - 2x250g Mevalia Bread Mix - 500g Mevalia Ciabattine - 260g Mevalia Cookies - 200g Mevalia Ditali - 500g Mevalia Frollini - 200g Mevalia Fruit Bar - 5x25g Mevalia Fusilli - 500g Mevalia Lattis - 500g Mevalia Pan Carre - 300g Mevalia Pane Casereccio - 220g Mevalia Penne - 500g Mevalia Pizza - 300g Mevalia Chocotino - 200g - (91MI20A00B54)Mevalia Spaghetti - 500g - (91ML00K00B78)Mevalia Rice Replacer - 400g - (91MP00J00B58) Patient Name Reason for request Delivery Address Postcode Special delivery requests Patient age Delivery Telephone Number Mobile number preferred Healthcare Professional Place Of Work Select your centre: Select your centre: - Select -Aberdeen Royal InfirmaryAddenbrooke's Hospital, CambridgeAlder Hey Children's Hospital, LiverpoolBetsi Cadwaladr Trust, North WalesBirmingham Children's HospitalBristol Royal Hospital for ChildrenBristol Royal InfirmaryDerriford Hospital, PlymouthEvelina Children's Hospital, LondonGlangwilli Hospital, CarmarthenGreat Ormond Street Hospital, LondonGuys and St Thomas' Hospital, LondonIpswich HospitalJohn Radcliffe Hospital, OxfordLeeds General InfirmaryLeicester Royal InfirmaryMusgrove Park Hospital, TauntonNational Hospital for Neurology and Neurosurgery, LondonNinewells Hospital, DundeeNorfolk & Norwich University HospitalNorthern General Hospital, SheffieldNottingham Children's HospitalNottingham University Hospital Other / not listedPoole HospitalQueen Elizabeth Hospital, BirminghamQueen Elizabeth University Hospital, GlasgowQueen's Medical Centre, NottinghamRaigmore Hospital, InvernessRHC & QEUH, GlasgowRoyal Aberdeen Children's HospitalRoyal Belfast Hospital for Sick ChildrenRoyal Berkshire Hospital, ReadingRoyal Derby HospitalRoyal Devon & Exeter HospitalRoyal Gwent Hospital, NewportRoyal Hallamshire Hospital, SheffieldRoyal Hospital for Children and Young People, EdinburghRoyal Hospital for Children, GlasgowRoyal Liverpool University HospitalRoyal Manchester Children's HospitalRoyal Victoria Hospital, BelfastRoyal Victoria Infirmary, NewcastleSalford Royal HospitalSheffield Children's HospitalSouthampton General HospitalSouthmead Hospital, BristolSt George's Hospital, LondonSt Luke's Hospital, BradfordThe Barberry, BirminghamThe Great North Children's Hospital, NewcastleUniversity Hospital of Wales, CardiffWestern General Hospital, EdinburghOther… Enter other… Select your centre: Select your centre: - Select -Aberdeen Royal InfirmaryAddenbrooke's Hospital, CambridgeAlder Hey Children's Hospital, LiverpoolBetsi Cadwaladr Trust, North WalesBirmingham Children's HospitalBristol Royal Hospital for ChildrenBristol Royal InfirmaryDerriford Hospital, PlymouthEvelina Children's Hospital, LondonGlangwilli Hospital, CarmarthenGreat Ormond Street Hospital, LondonGuys and St Thomas' Hospital, LondonIpswich HospitalJohn Radcliffe Hospital, OxfordLeeds General InfirmaryLeicester Royal InfirmaryMusgrove Park Hospital, TauntonNational Hospital for Neurology and Neurosurgery, LondonNinewells Hospital, DundeeNorfolk & Norwich University HospitalNorthern General Hospital, SheffieldNottingham Children's HospitalNottingham University Hospital Other / not listedPoole HospitalQueen Elizabeth Hospital, BirminghamQueen Elizabeth University Hospital, GlasgowQueen's Medical Centre, NottinghamRaigmore Hospital, InvernessRHC & QEUH, GlasgowRoyal Aberdeen Children's HospitalRoyal Belfast Hospital for Sick ChildrenRoyal Berkshire Hospital, ReadingRoyal Derby HospitalRoyal Devon & Exeter HospitalRoyal Gwent Hospital, NewportRoyal Hallamshire Hospital, SheffieldRoyal Hospital for Children and Young People, EdinburghRoyal Hospital for Children, GlasgowRoyal Liverpool University HospitalRoyal Manchester Children's HospitalRoyal Victoria Hospital, BelfastRoyal Victoria Infirmary, NewcastleSalford Royal HospitalSheffield Children's HospitalSouthampton General HospitalSouthmead Hospital, BristolSt George's Hospital, LondonSt Luke's Hospital, BradfordThe Barberry, BirminghamThe Great North Children's Hospital, NewcastleUniversity Hospital of Wales, CardiffWestern General Hospital, EdinburghOther… Enter other… Healthcare Professional Email Address Additional Email Healthcare Professional Contact Number I agree to Vitaflo processing my personal data as set out in the Privacy Policy. Vitaflo will supply the samples directly to the patient or (where the patient is under 13) the patient’s parent or guardian. By providing the patients’ name, address, date of birth and other information, and by ticking the box to acknowledge that you have read this advice, you confirm that you have obtained the patient’s consent (or the permission of the patient’s parent/guardian where relevant) to share the patient’s personal data with Vitaflo for the purpose of supplying product sample(s) to the patient. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit