Licensed Healthcare Professionals ONLY

Norgesic® provides physician drug samples to eligible health care professionals.


To receive samples by mail, please:

  • Complete the information in the digital form below.
  • Your signature and the date are required to authorize the sample request.

Eligible, validated MDs, DOs, NPs and other licensed practitioners will have samples shipped within 7–10 business days of receipt of the signed and dated Sample Request Form.