Request More Info about Preferred Retailer Program- Convatec

Convatec works with a group of Preferred Retail Suppliers to provide you with excellent customer service and dependable supply delivery. Convatec’s Preferred Retail Suppliers will:

Help you manage product orders in line with your insurance
Facilitate your insurance billing process to ensure you get the proper reimbursement for Medicare, Medicaid or private insurance
Help you select the right Convatec products to suit your personal needs
Ship your Convatec products straight to your home in discreet packaging
Send you timely reorder reminders
Protect your privacy in accordance with U.S. HIPAA guidelines

To learn more about Preferred Retail Suppliers that work with your insurance,  contact our me+ support team at 1-800-422-8811, cic@convatec.com or fill out this form.

First Name

Last Name

Email Address

Phone Number Type

Phone Number

Who is your current supplier of Ostomy Products? (If you don't have a supplier, skip this question.)

Do you have insurance? If so, who is your provider?

Data Usage Consent

Data Usage Consent* I authorize Convatec to contact me in regards to preferred retailers. I understand that my personal information submitted here will be used for this purpose. The use of my information may include contact by phone, email, text or mail from Convatec and its affiliates for coordination of products and services related to this program.

Consent to transfer Info if needed

Consent to transfer Info if needed I authorize Convatec to identify and refer me to a designated Convatec retailer if I decide to order Convatec products. I also authorize Convatec to disclose to my healthcare provider or to the providing manufacturer (1) my participation in the me+ program if enrolled, (2) the samples or products ordered, and (3) any feedback provided regarding the program or such products and samples.

Consent to marketing

Consent to marketing I authorize Convatec and its affiliates to contact me through commercial electronic messages (emails, text), traditional mail or phone calls for the purpose of communicating promotional information (marketing messages) about Convatec products, services, news, and events.

You can withdraw your authorizations at any time by contacting us by telephone at 1-800-422-8811, or by email at cic@convatec.com. You may also click on the ‘Unsubscribe’ link in the footer of the emails or text messages you may receive.