Samples – Patients

To order samples, please complete the form below:

* Required fields

Name*

Phone*

Address*

Email*

Address

Town/City*

Postcode*

Comments

 

What type of stoma do you have?

How do you obtain your appliances/ accessories?

How did you hear about us?

I would like to be kept informed with company/product updates

Are you willing to participate in product or service feedback?

BW2
Independence Fusion
Product Code: BW2

Sample - 1 applicator Yes, I'd like a sample

ARW1
Independence No Sting Adhesive Remover Wipes
Product Code: ARW1

Sample - 2 sachets Yes, I'd like a sample

SB2
AcuBond Strips
Product Code: SB2

Sample - 4 strips Yes, I'd like a sample

BW1
Independence No Sting Barrier Film Wipes
Product Code: BW1

Sample - 2 sachets Yes, I'd like a sample

P200AS
Independence Absorbent Strips
Product Code: P200AS

Sample - 6 strips Yes, I'd like a sample

RS1
Independence Adhesive Remover Spray
Product Code: RS1

Sample - 30ml can Yes, I'd like a sample

Please note we do not share your details with any 3rd parties. By clicking on ‘Send’ you are confirming that you accept the Privacy Policy

Comments are closed