Thank you for your interest in trying Hollister products. To receive your sample pack, please provide the following information:
First Name:
Last Name:
Address:
Street address only, no P.O. boxes accepted
Address 2 (optional):
Street address only, no P.O. boxes accepted
City:
Country
Algeria
Argentina
Australia
Austria
Bahamas
Bahrain
Belgium
Bolivia
Brazil
Canada
Chile
China
Columbia
Costa Rica
Cyprus
Czech Republic
Denmark
Ecuador
El Salvador
Finland
France
Germany
Greece
Guatemala
Honduras
Hong Kong
Hungary
Iceland
India
Ireland
Israel
Italy
Japan
Jordan
Kenya
Kuwait
Lithuania
Luxembourg
Malaysia
Mexico
Netherlands
New Zealand
Nicaragua
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Russia
Saudi Arabia
Singapore
Slovakia
South Africa
South Korea
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Thailand
Tunisia
Turkey
UK
Ukraine
United Arab Emirates
Uruguay
US
Venezuela
Vietnam
State/Province/Region:
Zip/Postal Code:
Phone Number:
E-mail:
I have a (select one):
Colostomy
Ileostomy
Urostomy
Other/Not sure
Pouch:
Your sample order will ship in 3-4 weeks. If you have any questions regarding these products, please contact Secure Start Services at 888.808.7456.
Offer Expires July 8, 2024.
ORDER REQUEST — MUST BE CHECKED TO SUBMIT SAMPLE REQUEST
For the purposes of processing, fulfilling, and communicating with me about the order that I am requesting , I consent to the processing of my personal identification, communication preferences, health information, product information, third-party information, transactional information and request details, where applicable, by Hollister, including by the Group Companies thereof (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 and SMS text message) that I have provided.
I agree
OPTIONAL CONSENT - FEEDBACK
For the purpose of receiving information about products, promotions, and other direct marketing campaigns , I consent to the processing of my personal identification, communication preferences, health information and request details, where applicable, by Hollister, includes by the Group Companies thereof (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 and SMS text message) that I have provided.
I agree to Direct Marketing
CONSUMER SERVICE MEMBERSHIP
For the purpose of enrolling in a free consumer service program and receiving the associated membership benefits , I consent to the processing of my personal identification, communication preference, health information, product information, third party information, transactional information, and request details by Hollister and its Group Companies (see link below) and its affiliated service company, where applicable. I understand that these services are free of charge, and there is no obligation to purchase anything to receive them. I understand that I am under no obligation to participate in any/ all of the applicable membership benefits, such as assistance identifying product supplier options, and receiving product samples and other complimentary items. I understand that Hollister, its Group Companies and affiliated product supplier, may communicate with me about consumer services, or as part of a membership benefit, using the contact information (postal address, email, phone, & sms text) that I have provided. Hollister may also share my personal and health information with my healthcare professional, doctor, healthcare product supplier, health insurance provider or other third parties as indicated in the data privacy notice. Hollister reserves the right to change the consumer service programs (Magokoro, QualiVida, Secure Start, StoConTe & Vivre+) at any time.
I agree to Consumer Service Membership
OUR PRIVACY POLICY