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Sample detail

It is important that you manage the consumers expectations and advise that they will receive a call from a Catheter product specialist within 72 hours to discuss this request with them.

Check list
Before you complete this web form for escalation please ensure you have checked the following:

  • Foley Catheter - Please refer the consumer back to their HCP for advice
  • Short term stock issue - Before escalation please first check whether there is a an alternative within the product range that can be added to the Coloplast Charter order in this instance. If no alternative available message your buddy instantly via Microsoft teams for support
  • HCP requested samples - please honour the HCP request and process the sample order
  • Carer requested sample - please complete form and escalate
  • Avoid duplicate leads - please check to see if there is an activity type Telehealth Lead. This will inform you whether a sample has already been sent and if there is already an interaction between the consumer and telehealth team before processing another escalation form.
    If a Telehealth activity is present, please message your buddy instantly via Microsoft teams to inform then that the consumer is on the telephone.


To ensure we process these sample requests quickly and efficiently we kindly ask that you complete all necessary fields on the form.

Please provide as much information as possible on the issue(s) within the comments field at the bottom of the form.
* Remember these will then be qualified by Telehealth before being sampled.
If ✝ is indicated - please specify product code and more information about what is required in comments
Does the escalation relate to an issue the consumer is facing, or is this simply a desired update to product?*
If the sample relates to an issue from the consumer, please indicate this below
If the sample relates to a desire from the consumer, please indicate this below.
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