Medical Sample Request Form

Request your All Over Ointment Sample Kit!

Contains: 25 10ml sample packets of All Over Ointment
Email*
Your Name*

First NameLast Name
Name of Your Practice*
ex. North County Pediatrics
What is your medical specialty?*
If "Other" please describe below
Website*
ex. www.tubbytodd.com
Phone Number*

Area CodePhone Number
Business Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Average Number of Patients Per Month*
Instagram
ex. @tubbytodd
Facebook
ex. Tubby Todd Bath Co.
Interested in joining our affiliate program?

YesNo
Our emails and texts are (almost) as fun as we are!

YES! I would like to receive marketing emails from Tubby Todd Bath Co.YES! I would like to be added to the Tubby Todd Bath Co. text list.
*By sending this form, I agree to be contacted by Tubby Todd Bath Co. in reference to my submission. Tubby Todd Bath Co. will review each submission for accuracy and reserves the right to deny any submission that does not relate to a certified medical organization.

*By signing up for text, you agree to receive recurring automated promotional and personalized marketing text messages (e.g. cart reminers) from Tubby Todd Bath Co at the cell number used when signing up. Consent is not a condition of any purchase. Reply HELP for help and STOP to cancel. Msg frequency varies. Msg and data rates may apply. (terms-conditions) and (https://privacy.tubbytodd.com/).
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Request your All Over Ointment Sample Kit!