Homecare Products

In order to receive samples, simply complete and submit the form below. It may be necessary for one of our customer service representatives to contact you regarding sizes or questions:

Unfortunately, at this time we are unable to process requests for samples outside the United States. Please contact your local sales representative or call 800-526-4455 for further assistance.

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Personal Information

First Name * MI Last Name * Address * City * State * Zip Code *
Email * Phone * Physician Name * Physician Phone * Physician Address * What product and manufacturer are you currently using? Where/Who do you get your current supplies from?

Order Form

BARD® Touchless Plus® Unisex Closed Catheter Kit Size

BARD® Latex Free Vinyl Urethral Catheters Size

BARD® Red Rubber Urethral Catheters Size

Bard® Leg Bags & Accessories Size

Drainage Bags

Miscellaneous Urological Supplies Size

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Your Privacy is very important to all of us here at BARD. BARD will not sell or rent customer information to others. This personal information collected by BARD is used to contact customers about BARD, our products and services. This information is only shared with other organizations (providers) to help them contact customers on behalf of Bard.

I have read and acknowledge Bards Privacy Statement*