Description

Please fill out the form

First Name*

Last Name*

Phone Number*

Email*

Select Your Closest Clinic

Please select the continence products you are currently using*:Intermittent catheters
Indwelling catheters
Urisheath/condom drainage with collecting bag
Absorbent products
Bowel Management
Other
None

Briefly Tell Us Your Areas Of Concern?

One of our Coloplast Care team members will call you shortly to discuss any identified issues. It isn’t easy to know if you need help to solve the problem from your GP or Specialist Nurse or if you can resolve the issue yourself.

Our Coloplast Care team are experienced in helping people solve continence issues. They are supported by our Clinical Nursing Team and are trained to give routine advice and recognise the signs that you may need to go back to a Specialist Nurse.

Order consent declarationBy providing your personal and sensitive data, you are consenting to Coloplast that we may process and store your data for the purposes to fulfill your request and to keep you informed about it via phone, text, email, or post. We may share your data with our sub-vendors when necessary to fulfill the request and transfer data securely outside of Australia to support our business operations. You may withdraw consent at any time without ramifications, by writing to privacyrequests@coloplast.com or calling us at 1800 653 317. For more information, please visit our privacy policy for consent.

contactUsBysendUsEmail

Headline

Please fill out the form

Thank you for your order