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Home >Bepanthen Sample Request Form

Bepanthen - Send me a Sample

To request your Bepanthen Sample, simply fill in this form, answer the few questions belows and press Submit. Samples will be sent to you from Alfred Gera & Sons, importers of Bepanthen in Malta and Gozo.

 

Name & Surname of Parent

Name of baby

Baby’s birthday

Address

Email

Telephone number

   

How do you feel about nappy rash?






How do you try and prevent nappy rash?




In case you replied Other above, please specify:

How frequently do you use a nappy cream/ointment?





When did your baby start experiencing nappy rash?








 

 

 

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