Enhancing Lives Together

Direct to Patient Sample Requests

This form is for direct to patient sample requests. Are you ordering samples for your dietetic department?

Are you in the Republic of Ireland?

Vitaflo Ireland have moved their sample form. To request a sample please visit the Vitaflo Ireland Sample form.

Please Select Your Samples:

If you are unable to process the sample as required, or would like supporting literature, please use the additional information area below to describe your request.

Low Protein Foods


Nutrition Support:

Supporting Literature

Only for Low Protein samples

Please note that any requests submitted without a delivery telephone number will not be accepted.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

**To avoid submitting multiple orders, please only press the SUBMIT button once. A confirmation email will be sent to confirm your request. (If you cannot see this e-mail please check your junk folder)**