ORDER YOUR FREE PRODUCT SAMPLES
Please complete this form to order product samples of our intermittent catheter systems. Please provide all necessary information so that we can process your order as quickly as possible. As soon as we have received your order, you will receive a confirmation from us by email.
Note for healthcare professionals: Please contact your local sales representative for samples or further information for all hospital products.
I declare that I have previously been trained by my doctor in the technique of self-catheterisation.
Please note: Intermittent Catheterisation (IC) should only be carried out after medical or nursing guidance (also including the hygienic measures necessary).
Declaration of Consent
Teleflex would like to inform you about products and new offers. We need your consent (as described in detail below) to process your personal information, to be allowed to contact you.
Please tick the type of information for which Teleflex may process your details in order to contact you.
Postal sending of samples of urological medical products of Teleflex and contact by telephone or email in order to advise me on the selection of product samples and to supply me with desired product samples. I may be contacted by phone or email to ensure correct handling of the product samples and to give feedback about satisfaction with the product samples
Sending/notification of information about urological medical products of Teleflex (via email, mail, phone, fax & SMS)
Sending invitations to surveys (including questionnaires) on urological products of Teleflex (via email, mail, phone, fax & SMS)
Sending of email newsletters
Telephone calls to consult and inform you on urological products of Teleflex
Note: You may decide at your own discretion to grant or deny any or all the above consents. If you give us a consent, you remain entitled to revoke your consent(s) at any time and without giving reasons. If you revoke, your above-mentioned data will no longer be processed for the above-mentioned purposes by Teleflex from the time of receipt of your revocation declaration. You can inform us of your revocation informally, in particular by: (Email to) firstname.lastname@example.org; (letter to) Teleflex, Grosvenor House, Horseshoe Crescent, Old Beaconsfield, Buckinghamshire, HP9 1LJ. If you wish to revoke only some of your above given consents, please let us know as well.
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