Become a Perrigo Store Brand Samples Member!

Are you interested in becoming a member of the Perrigo Store Brand Samples program? The Store Brand Samples Program enables consumers like yourself to try products in exchange for honest reviews. As a program member, you will periodically be invited to choose products to sample, at absolutely NO cost to you. Please fill out the interest form for a chance to be invited to our sampling community.

Question Title

* 1. Full Name

Question Title

* 2. Email Address

Question Title

* 3. Date of Birth

Date of Birth

Date

Question Title

* 4. What is your 5-digit zip code?

Question Title

* 5. How many children live in your household?

Question Title

* 6. What your children's ages?

Infant (0-12 months)

Baby (1-2 years)

Toddler (3-4 years)

Elementary school (5-10 years)

Middle school (11-13 years)

High school (14- 18 years)

Not applicable

Question Title

* 7. Which of the following categories interest you?

Infant formula

Allergy & Sinus Relief

Cough & Cold Relief

Pain Relief

Heartburn/Digestive Relief

Nicotine Replacement

Immune Support

Diabetes

Hair Regrowth

Women's Health

First Aid

Scar Treatment

Oral Care

None of the Above

Question Title

By clicking Submit, you confirm that all information above is true and accurate and that you have read and agree with our Privacy Policy, including the use of your name and email for the Perrigo Store Brand Samples Program. You also understand that submitting this form does not guarantee that you will receive an invitation to join the program. Only one account per household is allowed. Submitting this form multiple times will not increase your chances of receiving an invitation and may make you ineligible altogether. If you or someone in your household is already a member of the program, you are not eligible to complete this form.