Prescribers of YoniFit - Request for Materials
Thank you for completing the survey. Once it's complete, we'll send you your complimentary Provider Kit and any additional materials you request.
1.
Name:
2.
Email:
3.
Practice name and location (city and state):
4.
After this survey, we will send you the provider kit with prescribing instructions. Please let us know what additional materials you would like us to send. Select all that apply:
Prescription pads with instructions for patients
Wall posters
Patient pamphlets
Provider pamphlets
5.
What address should we send the kit and other requested materials to?
6.
Thank you! We will send you updates periodically and will be in contact once we are FDA approved. Please note here if:
- You have any additional comments.
- You would like to be contacted about investing in YoniFit.
- You would like to be contacted for any other reason.
Thank you for your time and we look forward to sharing our product with you.