Know that you have options!

We understand that figuring out which catheter may be right for you may be the last thing on your mind, but we’re here to provide options and help figure it out with you.

Complete this form to try the latest Convatec catheter technology for yourself.

Note: Prior to submitting your request for samples, please note that intermittent catheterization (IC) is a procedure that requires recommendation by a healthcare professional after a thorough patient assessment. Please ensure that your healthcare professional has prescribed the use of an intermittent urinary catheter.

Know that you have options!

We understand that figuring out which catheter may be right for you may be the last thing on your mind, but we’re here to provide options and help figure it out with you.

Complete this form to try the latest Convatec catheter technology for yourself.

Note: Prior to submitting your request for samples, please note that intermittent catheterization (IC) is a procedure that requires recommendation by a healthcare professional after a thorough patient assessment. Please ensure that your healthcare professional has prescribed the use of an intermittent urinary catheter.

*Required

First Name*

Last Name*

Address*

City*

Province*

Postal Code*

Country*

Telephone (do not include spaces)*

Email Address*

Please select the product you're interested in*

GentleCath™ Uncoated for Men

GentleCath™ Uncoated for Women

GentleCath Glide™ Hydrophilic for Men

GentleCath Glide™ Hydrophilic for Women

Cure Catheter™ Uncoated for Men

Cure Catheter™ Uncoated for Women

Cure Catheter™ Uncoated for Pediatric

Cure Catheter™ Hydrophilic for Men

Cure Catheter™ Hydrophilic for Pediatric

Cure Twist® for Women

Cure Ultra™ for Men

Cure Ultra™ for Women

Cure Catheter™ Closed System (Unisex)

Cure Catheter™ Pocket Catheter for Men

Catheter Size*

Catheter Tip*

Notes

How we use your data

Treating your personal data with care is important to us. Please read our privacy policy where you can find detailed information on how we protect and use personal data.

How we use your data

Treating your personal data with care is important to us. Please read our privacy policy where you can find detailed information on how we protect and use personal data.

Email

From time to time, we (Convatec) would like to send you commercial electronic messages (emails) for the purpose of communicating promotional information (marketing messages) about Convatec products, services, news, and events. By ticking the box, you consent to us emailing you for this purpose.

You can opt out of receiving marketing messages anytime by contacting us by telephone at 1-800-465-6302, or by email at convatec.canada@convatec.com. You may also click on the ‘Unsubscribe’ link in the footer of the emails you will receive.

Please note our calls come from number 1-800-465-6302 or as potential spam.

You can opt out of receiving marketing messages anytime by contacting us by telephone at 1-800-465-6302, or by email at convatec.canada@convatec.com. You may also click on the ‘Unsubscribe’ link in the footer of the emails you will receive.

Please note our calls come from number 1-800-465-6302 or as potential spam.

Multiple or single choice

*I agree to the processing of my personal data (name, surname, email address) by Convatec for the purpose of completing my product sample request. I know that providing data is voluntary, but necessary for the Customer Relations Center product specialist or nurse to assess which product(s) best meet(s) my specific requirements.

GentleCath™ & Cure™ Intermittent Catheters

Request Free Samples

Request Free Samples

Know that you have options!

Know that you have options!

How we use your data

How we use your data

GentleCath™ & Cure™
Intermittent Catheters