Confirmation of Consent

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Coloplast Confirmation of Consent


Confirmation of Consent

By providing my contact information and signing below, I hereby agree that Coloplast A/S and its affiliates (“Coloplast”) and their third party service providers may collect, use, transfer and process personal and health information about me for the following purposes (“Purposes”): 

  1. To provide support, guidance, and information about the proper use of Coloplast products;
  2. To interact with my healthcare provider, healthcare facility or supplier of product;
  3. To conduct consumer and marketing related research and analysis;
  4. To provide marketing and educational information related to Coloplast products and services;
  5. To process sample requests; and
  6. To perform other administrative tasks or to comply with applicable law. 

I agree that Coloplast may contact me by phone (including my cell phone if that is the number I provided), text message (sms), e-mail, hard copy letter, or other means of communication but only for the Purposes referred to above. I further understand that I must designate a phone number where I may be reached if I want to be contacted by phone. By designating a phone number and signing below, I provide my prior express written consent to receive calls, text messages and/or pre-recorded or artificial voice messages at that number from Coloplast, sent by automated technology. I understand that consent is not necessary to do business with Coloplast.

I understand that I can unsubscribe at any time if I do not want to receive communication from Coloplast other than to receive my product sample. To unsubscribe, I must either call Coloplast at 888-726-7872 or visit our website at:


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