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OSTOMY SUPPLIES
IBDMoms is here and ready to help if you are in need of ostomy supplies items. Please fill this out and we will do our best to get you what you need.
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NAME
*
Please give us your full name (First and Last)
Your answer
EMAIL
*
Your answer
PHONE
*
Your answer
ADDRESS
*
Your answer
PATIENT or CARGIVER
*
Please indicate whether you are a patient living with IBD or if you are caring for a patient with IBD.
Patient
Caregiver
Pediatric Patient
NEEDS
*
Ostomy bag
Alcohol Wipes
Adhesive Remover Wipes
Barrier Paste
Ostomy Belt
Gloves
Disposable Travel Bags
Disposable Floor or Counter Mats
Travel Wash
Tape
Scissors
Other:
Required
SIZES and BRANDS
*
Please indicate type, style, size and brands you need or prefer
Your answer
Please let us know any other challenges or needs you are facing that may not have been listed here.
Your answer
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