Fill out the form below to order your FREE sticker!
Remplir le formulaire ci-dessous pour commander un autocollant GRATUIT!

*First Name/ Prénom :

*Last Name/ Nom :

*Email address/ Adresse de courriel :

*Address/ Adresse :

*City/ Ville :

*Postal Code/ Code postal :

*Province/ Province :

*Phone Number/ Numéro de téléphone :

Do you or someone you know have a Spinal Cord Injury? Est-ce que vous ou quelqu’un que vous connaissez avez une lésion médullaire? Yes/ OuiNo/ Non

Support Services declaration of consentBy providing your personal and sensitive data, you are consenting to Coloplast Canada that we may process and store your data for the purposes to provide tailored services and healthcare professional reviewed guidance on a regular basis; to fulfill and inform you of your request by phone, text, email, or mail. We will also process your data to improve our products and services and may refer you to healthcare professionals if needed. Information provided to us by you or a third party will be used to process orders and for general administrative record-keeping purposes. The information may also be used or shared with a third party if required by law to provide you with information related to Coloplast’s products, services and wellness education. We will also let you know about relevant Coloplast products and services via phone, text, email, or mail (marketing). We may share your data with our sub-vendors when necessary to fulfill the request and transfer data securely outside of Canada to support our business operations. You may withdraw consent at any time without ramifications by writing to privacyrequests@coloplast.com or calling us at 1(866)293-6349. For more information, please visit our privacy policy for consent.

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Headline

At Coloplast, we’re motivated to fight for better care around the world, and we strive to ensure that the people who use our products, can access products and services to help them manage their conditions.

Order a Spinal Cord Injury Awareness Month sticker to raise awareness together this September!

Fill out the form below to order your FREE sticker!
Remplir le formulaire ci-dessous pour commander un autocollant GRATUIT!

Thank you for your order

Headline

At Coloplast, we’re motivated to fight for better care around the world, and we strive to ensure that the people who use our products, can access products and services to help them manage their conditions.

Order a Spinal Cord Injury Awareness Month sticker to raise awareness together this September!

Fill out the form below to order your FREE sticker! Remplir le formulaire ci-dessous pour commander un autocollant GRATUIT!

Thank you for your order

Fill out the form below to order your FREE sticker!
Remplir le formulaire ci-dessous pour commander un autocollant GRATUIT!