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Ostomy Sample Pack

Try free ostomy bags and accessories

Living with a stoma doesn’t mean compromising on quality of life! We are dedicated to ensuring that every person with an ostomy has the right pouch, regardless of the type of stoma.

Fill in the questionnaire below completely

In order to be able to send the correct ostomy material, we ask you to fill in the information below as carefully as possible. Fields marked with an asterisk (*) are mandatory.

Questions about your current ostomy equipment

What kind of stoma do you have? *

Which product(s) are you using now?

Which product do you want to test?

Do you use one-piece or two-piece product? *

What type of baseplate do you use? *

What is your stoma size/ diameter (mm)? *

Do you have a cut-to-fit or pre-cut baseplate? *

Questions about the ostomy material you want to try

Who will be using the samples? *

Which ostomy baseplate would you like to try? *

Which size of stoma bag do you prefer? *

Which colour style would you like to try? *

We want you to use the requested ostomy equipment safely

We will contact you if there are any uncertainties, for example about the type of ostomy material or the dimensions.

Please fill in the information below.

First Name *

Surname *

Street and house number *

Postcode *

Country *

Phone *

E-mail *

Comments

Marketing Permission

Yes, I would like to receive additional information about relevant therapies, products, solutions or events from B. Braun and its contracted distribution partners in future.

B. Braun Australia is the responsible organisation

The protection of the personal data of our customers is very important to us and we take it very seriously. Your personal data is subject to data protection and the collection and storage is subject to Australia Privacy Laws and our Privacy Policy. Under no circumstances will we pass on your personal data to third parties outside of the B. Braun Group or use or store them for any other purposes. Our staff has been trained to handle personal data and is obliged to comply with the data protection regulations.

Data Protection

I have read the data protection policy and agree with processing of my personal data according to the data protection policy. I can cancel this approval at any time.

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