Order samples
For free samples of our latest products please complete the form below. Please be aware that it may be necessary for us to contact you by phone if the form is incomplete. We normally dispatch samples within two working days but please allow up to 14 days for delivery.
If you are a colostomist ask to try our
New NovaLife.
If you would like copies of our liteature then please use the
Dansac Cart 'shopping feature' on our website. A guide of how to use this feature is available on our home page.
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| Stoma size (mm) |
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| Current appliance |
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Stoma type:
Please select the relevant stoma type below |
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| Colostomy
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Ileostomy
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Urostomy
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Cut-to-fit or
Pre-cut |
Additional information:
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1-piece or
2-piece |
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Opaque or
Clear |
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Accessories: |
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Press and hold down CTRL (or APPLE if using a Mac) to select more than one item |
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Please fill in relevant information:
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| Title: |
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Other:
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| Forename: |
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| Surname: |
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House No.: |
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(Enter N/A if not relevant) |
| Address 1: |
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| Address 2: |
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| Address 3: |
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| Post Code: |
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| Telephone, daytime: |
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| Telephone, evening: |
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| E-mail: |
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| Confirm E-mail: |
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| Comments: |
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Who is your current
delivery service provider |
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We would like to keep you informed about new Dansac products and services.
Your details will remain within our organisation.
Please tick this box if you do not wish to receive future information.
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