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*The samples request programme available only for Australia.

Urology- Sample Request Form For Patients

The following samples will be free of charge.  Normal Actreen® sample size is 5 of each product.  However if you select 4 or more different types per order, we will send 3 of each product. Urimed® sample is one per item.*

If you are a Healthcare Professional, please follow this link to use a different form.

HCP Sample Order Form

Order here

Fields marked with an asterisk are required.

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.

Thank you very much for your request!


It will be forwarded to a responsible contact person who will get in touch with you as soon as possible.

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