Type  Size  Film Colour
Closed Pouch
 
Maxi
Standard
Mini
 
   
   
Opaque
Clear
   
   
Drainable Pouch With Filter
Select Convex Closed
Select Convex Drainable

 Type Fabric  Film Colour
           
Paediatric with Clipless System
& Filter
       
Neonatal with Clipless System
& Filter
No starter hole
0-40mm
With Teddy Print Clear
Paediatric with filter
Without Teddy Print Opaque
Paediatric without filter
Neonatal without filter
       

Stoma Size
Your Stoma Size in mm
Other, please specify

Accessories
Pelican Protect
Skin Protective Wafers
SuperSeal Washers 20mm 30mm
Strip Paste
Citrus Fresh Deodorant
Dor Deodorant Drops
Pelican Paste
Ultra Barrier Cream
Citrus Fresh Adhesive Remover

Others, please specify



 
  
 
Job Title
(if applicable)
Title
First Name
Surname
Department
(if applicable)
Address
Postcode
Tel. Number
Email