Connecting healthcare providers and sales representatives.

When healthcare providers and their staffs do not have the time to comb through websites to contact their pharmaceutical, biotech or device sales rep, we will do it for them. We attempt to make the connection on their behalf, so they can focus on patient care and practicing medicine.

RepRequest by Pharma Dinners — Form

Please complete this form to the best of your ability. Once completed, the RepRequest By Pharma Dinners team will attempt to make contact with the sales rep for your practice. RepRequest By Pharma Dinners will contact you with an update as soon as possible and within 48 business hours. RepRequest By Pharma Dinners does not guarantee that it will be able to make contact with your sales rep, and it does not guarantee that a sales call will be scheduled or arranged. Dinner Group Inc. is not liable if RepRequest is not able to facilitate the connection between the healthcare provider's office and the sales rep. By continuing with this form and pressing "Submit," you are giving Dinner Group Inc. and its properties permission to retain and to use the information you provide pursuant to the RepRequest Terms of Service and the RepRequest Privacy Policy. By clicking "Submit," you also consent to being added to the PharmaDinners.com mailing list. Please contact contact@reprequest.us if you have any questions, comments or concerns. Any information provided by the pharmaceutical/biotech/device company is property of the pharmaceutical/biotech/device company. Any information provided by the medical practice is property of the medical practice. Dinner Group Inc. and its properties (PharmaDinners.com, Pharma Dinners Planning, In-Service Request and RepRequest) are not responsible for any of the information provided by the company to the medical practice and by the medical practice to the company. This form may not be used to transmit, retain, or share Protected Health Information. Dinner Group Inc. is neither responsible nor liable for any Protected Health Information transmitted, shared and/or leaked as a result of submitting the Protected Health Information through this form.

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