At Rapidcare we are easily able to arrange for information or product samples to be sent to you. Arranging a personal visit from a member of our professional staff or a patient association to help you to understand better the journey that lies ahead is no bother either.

Just fill in the form below and submit it to us for immediate, confidential attention.

Your Name

Your Address

Phone No.

Are you...

The patient A Relative Medical / Professional Other

if other, please specify

Please tell us what you need from us

Our information pack a call from our service team product samples a visit from another patient Patient association info Other- specify in box at the end of this form

If you are requesting samples please help us with the following information

I need to receive colostomy ileostomy urostomy samples?

I am currently using a bioltrol braun clinimed coloplast convatec dansac hollister marlen welland other product called with mm Stoma size  

which I obtain on prescription from not had operation yet Chemist/Pharmacy Amcare Clinimed Dansac Fittleworth Rapidcare Welland salts other  

I would prefer a 1 piece system 2-piece system dont know  

Is there anything else we can do for you?