1. FREEPHONE: 0800 012 6779 9.00am – 5.00pm,
Monday to Friday
www.clinidirect.co.uk
Ready and waiting
To register for the Clinidirect home delivery
service for your medical appliances, simply
complete this form and send it to us
with your prescription, using a Clinidirect
FREEPOST envelope.
Title:
Forename: Surname:
Date of Birth:
Address:
Postcode:
Home Tel No: Mobile:
Email:
Healthcare Professional Name:
HCP Tel No:
Hospital:
GP Name – Dr
GP Address:
GP Postcode: GP Tel No:
We will use the information you provide to dispense your prescription, which includes sharing it with
our appointed courier service and in some instances sharing it with your healthcare professional.
We will respect the privacy of your personal data and will comply with all relevant and current data
protection legislation. We will not disclose your personal data to any other third party. If you
wish to update or delete your personal information please write to us at: CliniSupplies Ltd,
Qualitas House, 100 Elmgrove Road, Harrow, Middlesex, HA1 2RW.
Friendly
Customer
Care Service
Caring for our customers with:
• A repeat dispensing service
• Dispensing all brands of stoma, woundcare and urology appliances
• Repeat prescription collection service
• Stoma appliance customisation
• Complimentary wipes
and disposal bags
with every order
• Urology patients
will also receive a
FREE night stand
Our team of trained staff are here to help take care of all your needs. We aim to
provide a personalised, discreet and polite service. We’re here 9.00am –5.00pm,
Monday to Friday to take your orders and answer any questions you may have.
Taking great care in supplying your
regular medical appliances
That’s it! We will then deliver your products on
time and discreetly, within 48 working hours*
!
ORDERS CAN BE PLACED SIMPLY:
1 By Post
Post your prescription using a
Clinidirect FREEPOST envelope.
2 By Phone (
Call us on our FREEPHONE number:
0800 012 6779.
3 By Email
Contact: info@clinidirect.co.uk
4 By Collection Service
We can even collect your repeat
prescription from your GP.
Here at Clinidirect, we strive to delight our customers
through our healthcare home delivery service that
offers a caring, dependable
and timely response
to your needs.
Whichever product
you use, our friendly
team will take great
care in managing your
order and individual
needs, one delivery
at a time.
*
Orders must be placed before 3pm.

2. Remove and keep me safe!
Cut hole to shape and
size of your stoma
Caring for your needs,
one delivery at a time!
Caring for your needs,
one delivery at a time!
Clinidirect Home
Delivery Service
Keep this safe
PRESCRIPTION RECORD
Please list your prescription
items and show your GP,
who will be able to provide
a repeat prescription for
your medical appliances.
Clinidirect
Home
Delivery
Service
Caring for your
needs, one delivery
at a time!
FREEPHONE:
0800 012 6779
9.00am – 5.00pm,
Monday to Friday
www.clinidirect.co.uk
Product Product Code Quantity
Specialist Nurse:
Telephone:
FREEPHONE: 0800 012 6779 9.00am – 5.00pm,
Monday to Friday
www.clinidirect.co.uk
FREEPHONE: 0800 012 6779 9.00am – 5.00pm,
Monday to Friday
www.clinidirect.co.ukClinidirect is a trademark of CliniSupplies Ltd. CS048_0612
FREEPHONE:
0800 012 6779
9.00am – 5.00pm, Monday to Friday
www.clinisupplies.co.uk
20 30 40 50 60 70 mm
¾
1 1/8
1 5/8
2
2 3/8
2 ¾
Patient’s Right Top Patient’s Left
This side away from skin
Stoma Cutting Guide
CliniDirect Home Delivery Service
DC Stoma guide.indd 3 19/06/2012 12:05