Hem Support Wear: Sample Kit Request Form

We're thrilled you're here and interested in our sample kit! We understand the importance of having the right tools and resources to support your patients effectively. That's why we've put together a sample kit featuring informational marketing materials and clinic samples designed to empower and educate your patients on our garments and how they can be a tool to help on their pelvic health journey.

🎁 What's Inside Our Sample Kit? 🎁

Informative Marketing Materials: Thoughtfully curated rack cards and business cards so your patients can easily get the information they need about Hem Support Wear and our garments.
Clinic Sample: Experience firsthand the quality and effectiveness of our support wear with a clinic sample that you can showcase to your patients. If you are interested in multiple sample sizes for your clinic, consider joining our Wholesale Program which includes a Try On Kit of 10 garments!

💡 How to Request Your Sample Kit 💡

Simply fill out the form below. We will review the information and ship your sample kit directly to your clinic. It's that easy!

*Please note that at this time we are only shipping Sample Kits to healthcare professionals based in the United States.

-- Get on our WAITLIST for shipping to Australia and New Zealand

Thank you for being a vital part of our mission to support women's wellness through education, empowerment, and community. Let's make a positive impact together!

Who are you requesting this clinic sample for?*

What is the name of your clinic?

Who should we address the sample kit to? (First Name)

Contact Person (Last Name, with Credentials-if any)

Please provide the best email address for communication regarding the sample kit shipment.

What is the best phone number to reach you for any follow-up questions or assistance?

Where should we ship the sample kit? Address (Number & Street)

Address Line 2 (Unit/Suite/Etc)

City

State

Zip Code

How many healthcare professionals work at your clinic? This will help us determine the amount of materials to send.

Approximately how many pelvic floor patients do you see in a month? This will help us determine the amount of materials to send.

We're curious! How did you hear about our sample kit program?

Are you interested in our wholesale program?*

Are you interested in our affiliate program?*

Is there anything else you'd like us to know or any specific requests regarding the sample kit?

Would you like to join our Healthcare Professionals newsletter? This is where we share about product updates, new products, promotions, and any company news. We send updates about once a month.*