Healthcare Professionals

Order your Male External Catheter samples

Please accurately fill out the form below. If you have questions about Coloplast catheters, please contact us by phone at

1-855-605-7588 or by email at samples@coloplast.com

Please provide the following information for the individual with an ostomy requesting this product:
Is this a cell phone or a land line? *

I currently use the following product(s):



Proper sizing is important. Please use our sizing guide and application techniques to select the right size for you
Please select the size(s) you would like to sample:








Coloplast Confirmation of Consent


 

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