Request Intermittent Catheter Samples

Please provide your information below
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Check this box if you are a Healthcare Professional.
If you are a retailer, DME or HME, please click here to contact us. 
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Are you a current or recently prescribed intermittent catheter user?*

A valid prescription is required in order to sample intermittent catheter products.
No payment information required. 

Cure Medical, LLC was acquired by ConvaTec Inc. By submitting your information, you are agreeing to ConvaTec's Privacy Policy and Health Information Consent Policy. If you would like to order ConvaTec's products, you authorize ConvaTec to identify and transfer you to a designated ConvaTec retailer. 
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You authorize ConvaTec to call, email, text or mail you information about ConvaTec's products and services. You may withdraw this authorization by contacting us at 1-800-422-8811,, or by mail at PO Box 270603, Oklahoma City, OK 73137. 
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