Request Samples

Healthcare Professionals

Carwin Pharma provides physician drug samples to eligible health care professionals.  To receive samples by mail, please:

Fill in the information in the form — your signature and the date are required to authorize the sample request.  Email the completed form to Carwin Pharmaceutical Associates, LLC @

Eligible, validated MDs, DOs, NPs and other licensed practitioners will have samples shipped within 3–5 business days of Carwin receiving the signed and dated Sample Request Form.

Printable Request Forms Below

Relafen DS/RyVent/

TriStart DHA/Quflora

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1301 HWY 36, Ste 11,
Hazlet, NJ 07730 USA

Our hours

9:00 AM – 5.00 PM
Monday – Friday

Contact us

Phone: 844.700.5011
Fax: 732.344.6155