Special Offers for
Healthcare Professionals

We regularly provide coupons and other special offers for healthcare professionals to share with their patients. We want to help you encourage your patients to experience the benefits of Florajen probiotics. Please provide the following information about your practice/store and we will send your requests directly to you.

We regularly provide coupons and other special offers for healthcare professionals to share with their patients. We want to help you encourage your patients to experience the benefits of Florajen probiotics. Please provide the following information about your practice/store and we will send your requests directly to you.



* Name of Facility:
* Facility Address:
Floor/Suite #:
* City:
* State/Zip:  / 
* First Name:
* Last Name:
* Title:
* Type of Healthcare Profession:
* Email:
* Business Phone:
Fax:
Home Phone:
Mailing Address:
(If different from above)
* How did you hear about Florajen products?


Please send me:
OR

Additional Comments:
 

By submitting this information you are permitting American Lifeline, Inc. to contact you with information about Florajen products. Your personal information will not, for any reason, be sold or transfered to any other parties.