Request your free samples by filling out the form below or call us at 1-855-430-9500.

Please note that intermittent catheters are a prescription product.  If you're requesting a sample of an intermittent catheter we require verification of a valid intermittent catheter prescription before we can send samples.   

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Intermittent catheters are a prescription product. To get your samples faster, please provide your birth date and supplier and/or clinic information so that we can confirm your prescription on your behalf.
Please help confirm my catheter prescription

Coloplast Confirmation of Consent

Coloplast Confirmation of Consent

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