Physician's Sample Request

Treating Patients With Dysautonomia

Do you treat patients with dysautonomia or POTS?  Are you looking for a medical grade electrolyte that has been clinically proven to manage symptoms of POTS?  NormaLyte is an oral rehydration solution using the WHO's new formula for rehydration that is great solution for your patients!  

What's in the Physician's Sample Package

The Physician's Sample Package is completely free to you, and we will even cover shipping!  When you submit the request for your facility or practice site you will receive the following:

  • 10 boxes of NormaLyte PURE
  • 10 boxes of NormaLyte Orange
  • 10 boxes of NormaLyte Grape
  • 10 boxes of NormaLyte Green Apple
  • Tri-folds for NormaLyte for patients

New Sample Requests (first time requests)

For new sample requests, we as that you fill out the form below.  Once filled, we will send you the link to request our physician's sample box, and you will be able to reorder as needed after that.  We encourage your office to reorder as needed!  

You only need to fill the form out once.

If you have previously ordered but never filled out this form: we request that you please fill out this one time form for all future orders.

If you have previously ordered and have filled the form out in the past:  no need to fill out the form again.  Email us at and we will get your sample box out.

If you have never ordered:  fill out the form, once it's approved you will receive notification of your order.  

Disclaimer:  NormaLyte offers free sample packs to physicians offices only.  These are not for the general public as a legitimate business address must be provided.  We will not ship to home addresses.  If we suspect you are not a doctor or a representative of a doctors office, your order will be cancelled.  We reserve the right to refuse samples to anyone.