Catalog Request

We offer a wide variety of products to meet your needs and are here to help you at any time.

-Mary, Senior Customer Care Representative

You can save $8.00 on your first order and save 5% on all future orders.
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Request a Free Catalog

Complete the order form below to receive a free HDIS Catalog with more than $40 worth of money saving coupons!

HDIS Catalog Request Form

Name

(Required)

Address

(Required)

City

(Required)

State

(Required)

ZIP Code

(Required)

Phone

(Required)

Are you interested in our services for yourself, or for someone under your care? And if so, what is their relation to you?

Would you mind providing us with the following information?
(If this is for someone else, please tell us about that person.)

Gender

Female
Male

Birthdate

What brand and type of products are currently used?
(Select all that apply; hold down the <Control> key to select more than one)

Brands	Types

About how many are used per day

Which type of product are you most interested in? If you select protective underwear or briefs, please include your size.

Protective Underwear (pull-on)

Moderate to Heavy Pads

Light to Moderate Pads

Briefs (with tape tabs)

Undergarments (with straps)

Guards for Men

Size (S, M, L, XL, XXL)

Request a FREE HDIS Catalog and $40
In Coupons.