Male compact catheter quality of life survey

Thank you for sharing your experience using a SpeediCath® Compact catheter

You must be over 18 years of age to participate in this survey. By participating, you consent to Coloplast using your product related responses for marketing and product improvement purposes. Your personal information will not be sold to or shared with any third parties. Coloplast may contact you for additional marketing opportunities, which will be subject to a separate agreement decided upon at that time. You may request to see the information that Coloplast has on file about you, as well as request at any time that the information is erased or that wrongly stated data is corrected. Inquiries or requests should besent to Continence Care Marketing, Coloplast Corp., 1601 West River Road N,Minneapolis MN 55411. All information that you give to Coloplast, including suggestions of changes or improvements, is the property of Coloplast and the usage of such information by Coloplast will not result in any compensation. Coloplast does not commit to implement anysuggestions that are made.

*Privacy Statement

Coloplast respects the privacy of your personal information and will protect the confidentiality of the information contained on this form. The only time the information may be used or shared is if it is (1) required by law; or (2) to provide you with information about Coloplast products, services and wellness education. You may be contacted by Coloplast, its agents, affiliates, contractors, or supply or service providers by telephone, email, US Mail, or other means of communication only for the purpose stated above. If you choose not to receive communication from Coloplast, please contact us at 1-888-726-7872 or email unsubscribe-us@coloplast.com  to request that communication be discontinued.