For Healthcare Professionals
Free Samples, Personalized Prescription Pads, Patient Instructions
Free Samples
In order to obtain samples of HalfLytely® and Bisacodyl Tablet Bowel Prep Kit (PEG-3350, sodium chloride, sodium bicarbonate and potassium chloride for oral solution and bisacodyl delayed-release tablet), please click on the link below to view the Sample Request Form, print the form, fill out completely, and fax back to the number givenbelow.
Sample Request Form (PDF)
Once this form has been completed, please fax to 781-843-7932.
You may also mail your request in to the following address:
Braintree Laboratories, Inc.
Attn: HalfLytely Sample Department
PO Box 850929
Braintree, MA 02185-0929
Personalized Prescription Pads
Braintree Laboratories also provides complimentary personalized prescription pads. If you would like to obtain them, please complete the following instructions:
- Submit a voided prescription form. Be sure all information listed on the form is accurate and up to date.
- On the voided form, indicate that you would like personalized pads made for the HalfLytely and Bisacodyl Tablet Bowel Prep Kit.
- Fax your request to 781-843-7932. Please write "Attention Personalized Prescription Pads" on your faxed request.
- You will receive your order approximately 3-4 weeks from date of request.
Patient Instructions
For additional information on either of these topics, please call 800-874-6756.
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