Sylk Kiwi fruit
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Want samples for your practice?

Simply fill out the form below and we'll send you some samples. All the information you provide will be kept private and not on-sold to any other company.

Please Note:  This request form is for use only by registered Health Professionals and their staff, within Australia.
It is not for consumer use and all details, which must be completed, will be checked prior to fulfilment.


 

  Title  
   
First Name
   
Surname
   

Practice Name
& Street Address

   
Practice Email address
   
Practice Phone Number
   
Practitioner/modality type
(if "Other" please specify in comments section)
   
Quantity of Sylk leaflets & trial sachets
   
Date required by
(As sachet samplers are packed for localised stockists, we require some notice but we will do our best to deliver to you within 21 days.)
   
Intended for / Usage / Comments
   
How did you hear about our sample service?
   
Have you tried Sylk yourself? Yes
No 
   
Would you personally like to be added to our promotional mailing list? Yes
No 
   
If so, but you'd rather have us contact you on a private email address, please advise this here:

IMPORTANT: Geneva Marketing is not always able to supply on request or for the quantity requested. Should this be the case, we will contact you by either email or phone. Plus we would appreciate it if you could give us maximum notice as we are sometimes out of stock and/or unable to supply within 5 working days.

Thank you for your interest in our unique and natural product.

 
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