D-Ostomy Subscription
&
Sample Request

Are you a patient or a clinician?

I'm a patient

I'm a clinician

I'm both

Do you prefer a closed or drainable pouching system?

Closed

Drainable

Anything else you would like to tell us about your thoughts or experiences with D-Ostomy?

Would you prefer supplies for a right or left sided ostomy?

Right

Left

First Name(Required)

Last Name(Required)

What is your email address?(Required)

What is your phone number?(Required)

Where should we send your samples?(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

By requesting these samples, you acknowledge and agree that Versipel, LLC may collect and share your personal contact information (including name, email, phone number and/or shipping address) with our partners, vendors, distributors, and affiliates (“Partners”). You agree to allow Partners to contact you regarding the requested sample, product information, or related healthcare offerings. This sharing is intended to facilitate sample delivery, provide technical support, and offer relevant product information. Your submission of this request for samples constitutes your express consent to this disclosure. You acknowledge that you have read and understand this Authorization and Waiver, have had the opportunity to ask questions, and agree to the terms set forth above. You further acknowledge that your contact information may be shared with multiple Partners and that individual Partner privacy practices may vary.(Required)

Yes

No

Would you like to subscribe for updates, request free samples, or do both?(Required)

Yes

No

Would you like to shop some more?

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About Us

Our mission is to develop products aimed at making life easier for people with ostomies. The D-Ostomy barrier can be rotated and positioned to suit any anatomical challenge, providing a snug and secure fit. Try the D-Ostomy today and feel the difference.