Product Sample Checkout | Hollister US


Thank you for your interest in Hollister Incorporated products. To request free product samples, please submit the information below. If necessary, the Hollister Incorporated Customer Service Team may contact you regarding this product sample request.

Customer Information
Physician Name
  • Please provide your prescribing Physician's name and phone number
Prescription File
  • In order to facilitate a Continence Care sample request, please upload a copy of your prescription.
  • May we contact you with future product information?

    By checking the box “Yes, I consent” below, I declare my consent that Hollister Incorporated, as well as its related companies, may collect, process, and use the personal information I provide for purposes of providing me with any product sample(s) I have requested, contacting me to follow up regarding any product sample(s) I have requested, and providing me with information about Hollister Incorporated and its products and services.

    Further information on Hollister Incorporated privacy practices can be found here.

The information provided herein is not medical advice and is not intended to substitute for the advice of your personal physician or other healthcare provider. This information should not be used to seek help in a medical emergency. If you experience a medical emergency, seek medical treatment in person immediately.