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Free Catheter Samples Request Form (UK Residents only)

Please complete the form below and we will provide enough samples for you to make your decision regarding suitability for you. For more samples please contact us with your requirements. If the catheters prove suitable, then for a continued supply, please approach your prescriber with the ordering information detailed on the packaging.

For more information, please call us on 01494 53 27 61.

* indicates a required field.

User information*

I confirm that I am a current user of intermittent catheters as prescribed by my healthcare professional
or
I am a Health Care Professional (A Territory Sales Manager will be in contact with you to discuss your requirements)
or
I am a parent / carer user of intermittent catheters

Email
Phone

* indicates a required field

Intermittent Catheter Product Required *

Please select which products you would like us to sample

Liquick x-treme Liquick base Liquick PURE
SafetyCat Active Liquick PLUS Flocath quick
Flocath Introgel Mobile SL MobiStom

All of the above are 'no-touch' catheterisation systems.

Catheter Length
Male
Female
Children

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