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 Complete this form to receive your free sample:

The new ULTRAFINE III is the smallest needle in the world today at 5mm. This special offer is available to residents of Canada only, limit of one sample per family. B-D pen needles are compatible with all insulin pens available in Canada.


First Name:
Last Name:
Address:
City:  
Province:  
Postal Code:  
Phone: 
E-mail:

What brand of insulin pen do you currently use?
B-D (Becton Dickinson) (Colour:White/Beige/Light Grey/Maroon/Multi-Colour)

OR

Novo (Novo-Nordisk) (Colour:Metal)

What B-D brand of pen needle are you using? 

B-D regular length

B-D short length

Please be assured that all information given will be held in the strictest of confidence.

For further information on the product you see here, or any other Becton Dickinson product, please visit our website at www.bdcanada.com
If you have any questions or comments call 1 (877) 237-2675 or e-mail us at info@bdsample.com