Hollister Sample Request

Try the ostomy skin barrier that's designed to keep healthy skin healthy

The innovative CeraPlus skin barrier with Remois Technology* is designed to maintain adhesive properties, and features a ceramide-infused formulation that helps protect against damage, dryness, and itching of the skin around the stoma.^1,2 The CeraPlus skin barrier is available on one- and two-piece pouching systems. Learn more about the benefits of ceramide.

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Please fill out the following form to get a free sample

Based on the information and preferences provided, we will send you a product option that best fits your needs. If you have any questions or would like to try something different, feel free to call us at 1.888.808.7456.

First Name: *

Last Name: *

Address: *

Phone Number: *

City: *

State: *

Zip: *

Email: *

Gender:

Surgery Date: *

Birth Date (mm/dd/yyyy):

Stoma Type: *

Stoma Size: *

Where is my stoma located?

Is your stoma located in a dip, crease or fold?

Pouching System Type:

Manufacturer of Current Pouching System:

Barrier Type:

Which company currently sends or delivers your supplies?

Current Product Number(s):

Address Two:

For the purpose of receiving information about products, promotions, and other direct marketing campaigns, I consent to the processing of my personal identification, communication preference, health information, and request details, where applicable, by Hollister, which includes its Group Companies (see link below). I understand that Hollister and its Group Companies may communicate with me about these topics, using the contact information (postal address, email, phone, & sms text) that I have provided.

For the purpose of processing, fulfilling, and communicating with me about the order I am requesting,* I consent to the processing of my personal identification, communication preference, health information, product information, third party information, transactional information, and request details, where applicable, by Hollister, which includes its Group Companies (see link below). I understand that Hollister and its Group Companies may communicate with me about my order, using the contact information (postal address, email, phone, & sms text) that I have provided.

Comments

Step 1: Contact Information

Fields marked with an asterisk(*) are required.

Step 2: Stoma Information

Fields marked with an asterisk(*) are required.

Step 3: Current Product Information

Fields marked with an asterisk(*) are required.

Nikitakis J and Breslawec H. International Cosmetic Ingredient Dictionary and Handbook. 15th ed. Washington, DC:Personal Care Products Council, 2014.
Feingold KR. The role of epidermal lipids in cutaneous permeability barrier homeostasis. Journal of Lipid Research 2007. 48: 2531-2546

Prior to use, be sure to read the Instructions for Use for information regarding Intended Use, Contraindications, Warnings, Precautions, and Instructions.

The Hollister logo and CeraPlus are trademarks of Hollister Incorporated. All other trademarks and copyrights are the property of their respective owners.

*Remois is a technology of Alcare Co., Ltd.

Not all products are CE marked.