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Request for samples

The purpose of this questionnaire is to collect basic information on your project in order to help us suggest the most suitable solution to answer your needs.

Please fill in whenever you can/find relevant, we will revert to you as soon as possible.

Your need

Is your product

Is it:

If you already know the viscosity, please specify:

cps

If you know the density, please specify:

g/L

Is it a drug product?


How long will the treatment be?
days
What will be the dose per use?
ml

Any specific feature of your formula that you would like to share?
Others :

Are you looking for specific functionnalities?
Others :

Do you have a preferred shape
Others :

In terms of customization, are you looking for a packaging

If you already have an idea of forecasted quantities, please specify

What is the estimated launch date of your product?

In which country is your product going to be marketed?

For the reply

Name *

Prénom *

Company *

Phone *

Function *

Email *

Address

City

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