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      To begin your Care sign-up, complete a few simple questions below:

      How long have you had your stoma?



      What type of stoma do you have?



      When did you last see your stoma care nurse?




      Where do you go for help with your stoma?






      When you seek help, are you able to get your issues resolved?



      Who supplies your stoma care products?








      How much stock do you like to keep at home, so you don't run out?



      If offered, would you want to see a stoma care nurse to discuss your challenges?

      By providing your personal and sensitive personal data on this form, you are consenting to Coloplast and Coloplast Charter using it for administration and analysis purposes and to process your order. We may share this information with healthcare professionals and other companies required for the delivery of your products or as required by law. We may also contact you to ask you to clarify your requirements and to ask you to complete customer satisfaction or other surveys, and may use 3rd parties to handle this as outlined in our Privacy Policy which can be found at Coloplast.co.uk/privacy.We often keep customers up to date with the latest information on the products and services we offer. Please indicate if you would not like to be kept informed by:




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