Request a Sample

A medical facility or clinician can request a Sample Rooke® Boot, BKA or Mitt.

Use the Form Below to Request a Sample

Name
First Last
Email
Phone
Shipping Information
Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please send me a sample of (check one)
- Vascular Boot
- BKA
- Mitt
Consent*
By checking this box, I am confirming that I am a qualified medical professional or work at a medical facility that is eligible for sample.

Don’t forget, your Rooke Rep is here to help with any questions!

CONTACT A ROOKE REP