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Attention! The Dex4 Educators Samples ordering system has changed. Please read the following carefully:

If you are a Diabetes Educator who is affiliated with a diabetes clinic or hospital, and using your Dex4 samples for patient education, please complete the application below.

Once the form is completed and your request is accepted, we will email you instructions showing you where to create your password. Once you password is created you will be able to order Dex4 Sample by clicking the above link.

We appreciate your help in emphasizing the importance of always being prepared, as low blood sugar can happen anytime, anywhere.

Please note: We do not ship to P.O. boxes
Please note: Dex4 Samples are only available in Canada

    Tell us about yourself* 

    Under 1818-3435-4445-5455-6465-7475-8485+
    Reason for contacting us*  
    Product / Category / Brand*  


    Diabetes Class Information:


    Yes, I would like to receive communications on related information, products, programs and services.

    *We are unable to supply hospital emergency rooms and clinical research studies with free samples so please contact wholesalers such as McKesson, Cardinal and AmerisourceBergen to purchase Dex4 Fast-Acting Glucose products.