Hernia Guide - Stomo Medical - Coloplast Canada

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Download a free copy of the Managing a Parastomal Hernia guide Téléchargez un exemplaire gratuit du guide Gestion d’une Hernie Péristomiale.

Please select one / S'il vous plait sélectionner en un:*I have an ostomy / J’ai une stomie
I am a caregiver of someone with an ostomy / Je prends soin d’une personne stomisée
I am a healthcare professional (HCP) / Je suis un professionnel (PS)
Other

HCPs, please enter facility name / PS, veuillez saisir le nom de l'établissement:

If Other, please explain / Si autre, veuillez expliquer:

First name / Prénom:*

Last name / Nom de famille:*

Address / Addresse:*

City / Ville:

Province*

Postal Code / Code postal:*

Email address:*

Surgery Date / date de la chirurgie:*

Phone number / Numéro de téléphone:*

Please check the box to acknowledge that you have read and understood the Declaration of Consent.

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