By signing up for the MyOstomy app trial, independently or through my healthcare provider, 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.

At any time you may contact Coloplast and request that we delete any of your personal data that we have collected or request that Coloplast stop contacting you by mail, phone, and text messages. More information on your rights and on how Coloplast treats your data is available at www.coloplast.us as well at 1-888-726-7872. By submitting this form, I confirm that I am of legal age, have read and understood this declaration.