Resources

Product Guide View Coloplast's continence, ostomy, skin and wound care products and accessories and request free samples. (effective October 2016) View the product guide and request free samples

Join Coloplast Care Coloplast Care is a personal support program meant to extend the help and education you get from your health care provider. Click here to learn more about Coloplast Care

Legal Coloplast's corporate responsibility is guided by a set of policies that describe our way of doing business See our Policies & Reports

Forms and Requests View Forms and Requests

Are you looking for Coloplast product samples? Please provide the information listed below.

First name:*

Last name:*

Phone number:*

Is this a cell phone or a land line?*cell phone
land line

Email:*

Address:*

City:*

State:*

Zip Code:*

Who makes the ostomy/continence product that you are currently using?

I would like information regarding*:Ostomy products
Bladder & Bowel Products
Wound Products
Skin Products
Surgical Urology Products

If you have an ostomy, when was your surgery date?(DD/MM/YYYY):*

Coloplast Confirmation of Consent

Please check the box to acknowledge that you have read and understood the Confirmation of Consent.