Request your Promin / Taranis / metaX samples – United Kingdom

Patient's Full Name (required)

Patient's Date of Birth (required)

Your Email (required)

Telephone (required)

Address Line 1 (required)

Address Line 2 (required)

Town (required)

Post Code (required)

Country (required)
EnglandScotlandWalesNorthern Ireland
IMD Type (required)
Phenylketonuria (PKU)Tyrosinemia (TYR)Homocystinuria (HCU)Urea Cycle Disorder (UCD)Other
Samples Required (required)
Promin LP SpiralsPromin LP ShellsPromin LP SpaghettiPromin LP AlphabetsPromin LP MacaroniPromin LP ElbowsPromin LP Flat NoodlesPromin LP Tri Colour SpiralsPromin LP Tri Colour ShellsPromin LP Tri Colour AlphabetsPromin LP Tri Colour ElbowsPromin LP Imitation RicePromin LP Cous CousPromin LP PastamealPromin LP Lasagne SheetsPromin LP Pasta in Sauce Tomato, Pepper & HerbPromin LP Pasta in Sauce Cheese & BroccoliPromin LP Pasta in Sauce MoroccanPromin LP Hot Breakfast OriginalPromin LP Hot Breakfast Apple & CinnamonPromin LP Hot Breakfast ChocolatePromin LP Hot Breakfast BananaPromin LP Burger Mix OriginalPromin LP Burger Mix Lamb & MintPromin LP Sausage Mix OriginalPromin LP Sausage Mix Apple & SagePromin LP Sausage Mix Tomato & BasilPromin LP Rice Pudding OriginalPromin LP Rice Pudding ApplePromin LP Rice Pudding BananaPromin LP Rice Pudding StrawberryPromin LP Dessert Chocolate & BananaPromin LP Dessert Strawberry & VanillaPromin LP Dessert CustardPromin LP Dessert CaramelPromin LP Snax Cheese & OnionPromin LP Snax Salt & VinegarPromin LP Snax JalapenoPromin LP Snax Ready SaltedPromin LP Breakfast Bar Chocolate & CranberryPromin LP Breakfast Bar CranberryPromin LP Breakfast Bar Apple & CinnamonPromin LP Breakfast Bar BananaPromin LP Xpot All Day ScramblePromin LP Xpot Beef & TomatoPromin LP Xpot Rogan Style CurryPromin LP Xpot Chip Shop CurryPromin LP Macpot Macaroni CheesePromin LP Macpot Tomato MacaroniPromin LP Potato Pot Cabbage, Bacon & CroutonsPromin LP Potato Pot Onion & CroutonsPromin LP Potato Pot Sausage & CroutonsPromin LP Soup Creamy Tomato & CroutonsPromin LP Soup Creamy Chicken & CroutonsPromin LP Soup Minestrone & CroutonsPromin LP Soup Pea & Mint & CroutonsPromin LP Cheese Sauce MixPromin LP All Purpose Baking MixPromin LP Potato Cake MixPromin LP CroutonsPromin LP Fresh Baked White Sliced BreadPromin LP Fresh Baked Brown Sliced BreadPromin LP Fresh Baked Bread BunsPromin LP BreadcrumbsTaranis Lemon CakeTaranis Apricot CakeTaranis Pear CakeTaranis Chocolate Chip CookiesTaranis Chocolate Chip BiscuitsTaranis Raspberry Shortbread BiscuitsTaranis Biscuits Caramel ShardsTaranis Shortbread BiscuitsTaranis Pause Dessert CaramelTaranis Pause Dessert StrawberryTaranis Fish SubstituteTaranis Pancake & Waffle MixTaranis Dalia LiquidTaranis Natural Cake MixTaranis Risotto SubstitutemetaX YogumaxxPromin LP Cake Mix ClassicPromin LP Cake Mix ChocolatePromin LP Scrambled Egg & Omelette MixPromin LP Cereal ChocolatePromin LP Cereal Banana
metaX XPhe jump & XPhe minis Protein Substitute Samples Required: --- (For patients with PKU and HyperPhe only (XPhe jump suitable from 3 years of age / XPhe minis suitable from 7 years of age))
--- Take a look at our XPhe Customer Rewards Club below...
XPhe jump Cola 10XPhe jump Wild Berry 10XPhe jump Orange 10XPhe jump Neutral 10XPhe jump Vanilla 10XPhe jump Tropical 10XPhe jump Cola 20XPhe jump Wild Berry 20XPhe jump Orange 20XPhe jump Neutral 20XPhe jump Vanilla 20XPhe jump Tropical 20XPhe minis tablets
Dietician Full Name: (required)

Dietician Full Hospital Name: (required)

I consent for Firstplay to contact me via:
EmailTelephoneOpt Out
I consent for Firstplay to contact me about my sample request:
YesNo

Δ