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Complete the online form below to receive a FREE 1ct sample of Salonpas® Lidocaine FLEX Patch.

Limit one sample per household. Duplicate requests will not be honored. Offer valid only in the contiguous United States (i.e. excluding Alaska and Hawaii), and while supplies last.

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* When did you first hear about Salonpas Pain Relief Patches?

Which Salonpas products do you currently use or have used in the past?
(Select all that apply)

* Which of these describe your past experience with Salonpas Pain Relief Patches?

* How did you learn about this offer?
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* How are you planning to use your sample of Salonpas Lidocaine FLEX Patch?

* What is your age range?


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Disclaimer: By providing your name and other personal information above and clicking the “REQUEST FREE SAMPLE” button below, you authorize Salonpas and its agents to provide you with information, including promotional and product materials, regarding offers, services and programs, or other Salonpas products that may be of interest to you, and to contact you by postal mail, email, or telephone to discuss Salonpas products and obtain feedback (for market research purposes). For more information regarding Salonpas’ practices with respect to personal data, please visit https://us.hisamitsu/privacy-policy.

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Please allow 6-8 weeks for delivery.