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Doctor Samples

Doctor Samples Program

REVIVOL-XR Advanced Hemorrhoid Cream is available as a free sample for verified healthcare professionals. Submit the application below; we review within 24-48 hours and email you portal access plus 5 single-use sample codes.

Limit: 5 samples per provider every 30 days. Refill requests after 30 days use the same email on file.

Eligibility

Active healthcare professionals with a valid NPI number. Eligibility may vary by specialty.

Priority specialties: Gastroenterology, Colon & Rectal Surgery, OB-GYN, Family Medicine, Internal Medicine, Urgent Care, NP/PA/CNM, PharmD. Other specialties reviewed case-by-case.

Application Form

All fields required. We verify NPI on NPPES before approval.

For questions, please contact us.