MANUFACTURER'S INFORMATION REQUEST FORM

Please Note: This form is to be used only by qualified manufacturers and distributors of foods, nutraceuticals, beverages cosmeceuticals and pharmaceuticals.

For all enquiries for NAMMEX Mushroom Extracts, please fill out the

[ MUSHROOM EXTRACT INQUIRY FORM ]

Requests for Samples
If you wish to receive samples, please fill out this Manufacturer's Information Request Form completely, making sure to include your direct phone number and email address. We will contact you with instructions on how to receive samples. Thank you for your cooperation.