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Lofric Sample Order Form
DISCOVER
Lofric Sample Order Form
Lofric Sample Order Form
Select style and size and complete your delivery details below to receive a sample pack of 5 Lofric catheters. To see the full LoFric catheter range or request samples of other LoFric products, please contact Mediplast Australia Customer Care on 1800 622 492 or customerserviceau@mediplast.com.
LoFric Origo
40cm. Choose size and tick box if Tiemann tip required.
CH10
CH12
CH14
CH16
CH18
Tiemann (optional)
Tiemann
LoFric Sense
15 cm. Choose size.
CH 8
CH 10
CH 12
CH 14
2. Delivery details. Patient consent must be obtained prior to submitting this form to Mediplast Australia.
Patient´s name
Patient´s Postal Address
Patient´s City
Patient´s State
Patient´s Postcode
Patient´s Contact number
Patient´s Email
Funding
Self-funding
NDIS
CAPS
DVA
Other
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Prescriber´s name
Prescriber´s Postal Address
Prescriber´s City
Prescriber´s State
Prescriber´s Postcode
Prescriber´s Contact number
Prescriber´s Email
Contact
Mediplast Customer Service
Phone: 1800 622 492
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LoFric Catheters
Products
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Discover PARI
Discover LoFric
Discover Navina
Resource Center
--------------------------------------
Injection / Infusion
Inhalation Therapy
+
PARI inhalation devices
PARI nebulisers
PARI portable nebuliser
PARI accessories and parts
PARI PEP system
Mucoclear
PEP/RMT
Respiration
+
PEP/RMT
Continence
+
LoFric Catheters
Navina for Bowel irrigation
Surgery
+
Surgical accessories
Wound drainage
Positioning straps
Wound care
+
Compression
Suture strips
Tubular bandages
Fixation and support bandage
Foam dressing
Film dressing
Adhesive non-woven dressings
IV fixation
Orthopaedic padding
Vaginal and Injection swabs
Nutrition
+
VitABDECK
About Us
-
Ownership
History
Sustainability
Quality
Career
Whistleblowing service
Home
Search
Buy Now
Products
About Us
News
Contact Us
Resources