Prescription Pads

In order to help your office support enuresis treatment more efficiently, Try for Dry offers pre-printed Ditropan prescription pads to our affiliate healthcare providers. Each pad contains 50 prescriptions and they are available at no cost to your practice.

Pre-printed prescriptions are available for:

Ditropan
DDAVP
Senekot
Enuresis alarm

How to Obtain Free Prescription Pads
To obtain free pre-printed prescription pads, submit the form below:
*= Required

*Your Name:

Doctor's Name,
if support staff is
sending the request

*Medical facility:

*Postal address
of medical facility:


Address

City	State	Zip Code

*Phone number:

Fax number:

*Email address:

Upon receiving a request we will send out a letter to confirm the validity of the medical facility. Once confirmation is received we will mail your free pads.