CONTINENCE PRODUCTS

SAMPLE ORDER FORM

ORDERED BY

DELIVERY ADDRESS

SAMPLES REQUIRED

LINERS

GENDER

Waist (cm)

Total Capacity (mL)

Working Capacity

Sample Required Please tick

Description

Superior Health Code

Supplier Code

Unisex

N/A

45

25

Tena Liner Length

INCT658-30

2309658

Unisex

N/A

67

50

Poise Liner Regular

INCK853-26

91853

Unisex

N/A

75

40

Tena Liner Long Length (39)

INCT659-39

2309659

Unisex

N/A

93

70

Poise Liner Extra Long

INCK859-22

1859

PADS

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Male

N/A

275

193

Tena Men Level 1

INCT658-12

750658

Unisex

N/A

350

245

Tena Pad Extra Standard Length (24)

INCT441-24

760781

Unisex

N/A

370

N/A

Poise Pad Super

INCK840-14

91840

Male

N/A

450

315

Tena Men Level 2

INCT759-10

750759

Male

N/A

535

N/A

Depend Guards

INCK068-12

19068

Unisex

N/A

540

N/A

Poise Pad Extra

INCK135-12

91862

Unisex

N/A

585

410

Tena Pad InstaDRY Standard Length (20)

INCT503-20

760852

Unisex

N/A

600

420

Tena Pad InstaDRY Long Length

INCT946-6

760860

Unisex

N/A

700

N/A

Poise Pad Extra Plus

INCK140-10

91691

Male

N/A

710

497

Tena Men Level 3

NCT836-8

750836

Unisex

N/A

770

N/A

Poise Pad Overnight

INCK142-8

91871

Unisex

N/A

800

560

Tena Pad InstaDRY Extra Long Length

INCT644-8

760946

Unisex

N/A

860

602

Tena Pad Super

INCT730-30

757730

Unisex

N/A

960

672

Tena Pad Maxi Night

INCT017-14

2309017

Female

N/A

1029

N/A

MoliCare Premium lady pad

INCS670-14

168 670

Pull Ups

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

45-70

1361

N/A

MoliCare Premium Mobile Extra Small 6 drops

INCS840-14

915 840

Unisex

60-90

1791

N/A

MoliCare Premium Mobile Small 8 drops

INCS871-14

915 871

Unisex

65-85

1440

1008

Tena Pants PROskin Plus Small

INCT414-14

792632

Female

71-102

920

N/A

Depend Real Fit® Underwear Medium

INCK635-8

19635

Male

71-102

1320

N/A

Depend Real Fit® Underwear Medium

INCK605-8

19605

Female

71-102

1320

N/A

Depend Real Fit® Underwear Super Medium

INCK645-8

19645

Unisex

71-102

1450

N/A

DEPEND Underwear Super Unisex Small/Medium

INCK615-12

19615

Unisex

71-102

2000

N/A

DEPEND Underwear Super Plus Unisex Small/Medium

INCK610-10

19610

Female

75-100

880

616

Tena Women Discreet Black Medium

INCT520-10

795520

Female

75-100

880

616

Tena Womens Discreet White Medium

INCT210-8

796210

Male

75-105

1010

707

Tena Men Active Fit Navy Medium

NCT533-9

772533

Female

75-105

1010

707

Tena Women Discreet Creme Medium

INCT532-18

782532

Unisex

80-110

1100

770

Tena Pants PROskin Normal Medium

INCT528-18

791528

Unisex

80-110

1440

1008

Tena Pants PROskin Plus Medium

INCT514-14

792539

Unisex

80-110

2010

1407

Tena Pants PROskin Super Medium

INCT512-12

793520

Unisex

80-110

2550

1750

Tena Pants PROskin Maxi Medium

INCT510-10

794512

Male

80-120

1455

N/A

MoliCare Premium Men Pants Medium 5 drops

INCS827-8

915 827

Unisex

80-120

1662

N/A

MoliCare Premium Mobile Medium 6 drops

INCS832-14

915 832

Unisex

80-120

2015

N/A

MoliCare Premium Mobile Medium 8 drops

INCS872-14

915 872

Unisex

80-120

2626

N/A

MoliCare Premium Mobile Medium 10 drops

INCT878-14

915 878

Female

95-125

880

616

Tena Women Discreet Black Large

INCT623-9

795623

Female

95-125

880

616

Tena Women Discreet White Large

INCT320-8

796320

Male

95-125

1350

945

Tena Men Pants Level 4 (M/L)

INCT340-8

798340

Male

95-130

1010

707

Tena Men Active Fit Navy Large

INCT2629-8

772629

Female

95-130

1010

707

Tena Women Discreet Creme Large

INCT629-16

782629

Unisex

97-127

1450

N/A

DEPEND Underwear Super Unisex Large

INCK616-12

19616

Unisex

97-127

2000

N/A

DEPEND Underwear Super Plus Unisex Large

INCK611-9

19611

Female

97-162

920

N/A

DEPEND REAL FIT® Underwear Large

INCK636-8

19636

Male

97-162

920

N/A

DEPEND REAL FIT® Underwear Large

INCK606-8

19606

Female

97-162

1320

N/A

DEPEND REAL FIT® Underwear Super Large

INCK646-8

19646

Unisex

100-135

1100

770

Tena Pants PROskin Normal Large

INCT628-18

791628

Unisex

100-135

1440

1008

Tena Pants PROskin Plus Large

INCT614-14

792613

Unisex

100-135

2010

1407

Tena Pants PROskin Super Large

INCT612-12

793614

Unisex

100-135

2550

1750

Tena Pants PROskin Maxi Large

INCT610-10

794623

Unisex

100-150

1963

N/A

MoliCare Premium Mobile Large 6 drops

INCS833-14

915 833

Unisex

100-150

2279

N/A

MoliCare Premium Mobile Large 8 drops

INCS873-14

915 873

Unisex

100-150

2616

N/A

MoliCare Premium Mobile Large 10 drops

INCT879-14

915 879

Unisex

120-160

1100

770

Tena Pants PROskin Normal Extra Large

INCT715-15

791761

Unisex

120-160

1440

1008

Tena Pants PROskin Plus Extra Large

INCT712-12

792710

Unisex

120-160

1600

933

Tena Pants PROskin Super Extra Large

INCT3712-12

793713

Female

122-162

920

N/A

DEPEND REAL FIT® Underwear Extra Large

INCK604-8

19604

Female

122-162

1320

N/A

DEPEND REAL FIT® Underwear Super Extra Large

INCK647-8

19647

Unisex

122-162

1450

N/A

DEPEND Underwear Super Unisex Extra Large

INCK617-12

19617

Unisex

130-170

2140

N/A

MoliCare Premium Mobile Extra Large 6 drops

INCS834-14

915 834

Unisex

130-170

2757

N/A

MoliCare Premium Mobile Extra Large 10 drops

INCT880-14

915 880

Unisex

157-203

1440

1008

Tena Pants PROskin Plus Extra Extra Large

INCT850-12

792862

Belted

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

61-87

1522

1065

Tena Flex PROskin Plus Small

INCT3130-30

723130

Unisex

61-87

1833

1283

Tena Flex PROskin Super Small

INCT4130-30

724130

Unisex

61-87

2654

1858

Tena Flex PROskin Maxi Small

INCT122-22

725122

Unisex

70-115

2900

N/A

DEPEND Flex Super Plus Medium

INCK741-14

8741

Unisex

71-102

1780

1246

Tena Flex PROskin Plus Medium

INCT230-30

723230

Unisex

71-102

2179

1525

Tena Flex PROskin Super Medium

INCT4230-30

724230

Unisex

71-102

2979

2085

Tena Flex PROskin Maxi Medium

INCT222-22

725222

Unisex

71-102

3866

2706

Tena Flex PROskin Ultima Medium

INCT220-20

725220

Unisex

83-120

2081

1456

Tena Flex PROskin Plus Large

INCT3330-30

723330

Unisex

83-120

2292

1604

Tena Flex PROskin Super Large

INCT4330-30

724330

Unisex

83-120

3601

2521

Tena Flex PROskin Maxi Large

INCT322-22

725322

Unisex

83-120

4257

2980

Tena Flex PROskin Ultima Large

INCT320-20

725320

Unisex

95-135

3400

N/A

DEPEND Flex Super Plus Large

INCK739-14

8739

Unisex

105-153

2337

1626

Tena Flex PROskin Plus Extra Large

INCT3430-30

723430

Unisex

105-153

2906

2034

Tena Flex PROskin Super Extra Large

INCT4430-30

724430

Unisex

105-153

4476

3133

Tena Flex PROskin Maxi Extra Large

INCT421-21

725421

Unisex

105-153

5100

3570

Tena Flex PROskin Ultima Extra Large

INCT400-17

725400

Pads (All-In-One)

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

49-74

1410

987

Tena Slip PROskin Extra Small

INCT430-30

710430

Unisex

54-88 (hip)

1860

N/A

DEPEND Briefs Normal Small

INCK734-20

1734

Unisex

56-75

1650

1155

Tena Slip PROskin Plus Small

NCT530-30

710530

Unisex

56-75

1760

1232

Tena Slip PROskin Super Small

INCT130-30

711130

Unisex

56-75

2160

1512

Tena Slip PROskin Maxi Small

INCT824-24

710824

Unisex

70-110 (hip)

2300

N/A

DEPEND Briefs Normal Medium

INCK743-10

19743

Unisex

72-122

1843

1290

Tena Slip PROskin Plus Medium

INCT100-12

370100

Unisex

72-122

2249

1574

Tena Slip PROskin Super Medium

INCT900-10

369900

Unisex

72-122

2865

2005

Tena Slip PROskin Maxi Medium

INCT700-9

369700

Unisex

80-120 (hip)

3050

N/A

DEPEND Briefs Super Medium

INCK737-20

1737

Unisex

80-120 (hip)

3520

N/A

DEPEND Briefs Super Plus Medium

INCK410-15

17410

Unisex

82-144 (hip)

2600

N/A

DEPEND Briefs Normal Large

INCK744-8

19744

Unisex

92-144

2146

1502

Tena Slip PROskin Plus Large

INCT200-12

370200

Unisex

92-144

2667

1867

Tena Slip PROskin Super Large

INCT000-10

370000

Unisex

92-144

3810

2667

Tena Slip PROskin Maxi Large

INCT800-9

369800

Unisex

120-150 (hip)

3720

N/A

DEPEND Briefs Super Large

INCK738-20

1738

Unisex

120-150 (hip)

4300

N/A

DEPEND Briefs Super Plus Large

INCK390-15

17390

Unisex

133-163

2400

1680

Tena Slip Bariatric PROskin Super X Large

INCT501-28

711023

Unisex

140-170 (hip)

4300

N/A

DEPEND Briefs Super Plus Extra Large

INCK400-15

17400

Unisex

163-178

2650

1855

Tena Slip Bariatric PROskin Super 2X Large

INCT401-32

61490

Unisex

173-243

3080

2156

Tena Slip Bariatric PROskin Super 3X Large

INCT391-8

61391

Pads (Inserts)

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

N/A

1200

840

Tena Comfort Normal

INCT291-20

2311291

Unisex

N/A

1300

N/A

DEPEND Anatomic Pads - Normal

INCK940-16

19940

Unisex

N/A

1600

1120

Tena Comfort Plus

INCT803-20

2335803

Unisex

N/A

1700

N/A

DEPEND Anatomic Pads - Plus

INCK946-15

19946

Unisex

N/A

2500

N/A

DEPEND Anatomic Pads - Super

INCK960-15

19960

Unisex

N/A

2500

1750

Tena Comfort Super

INCT293-20

2311293

Unisex

N/A

3000

N/A

DEPEND Anatomic Pads - Super Plus

INCK970-15

11970

Unisex

N/A

2000

1400

Tena Comfort Extra

INCT292-20

2311292

Disposable Underwear

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

65-95

N/A

N/A

DEPEND Stretch Pants - S/M

INCK800-300

19800

Unisex

70-90

N/A

N/A

Tena Fix Small

INCT028-25

754028

Unisex

80-100

N/A

N/A

Tena Fix Medium

INCT029-25

754029

Unisex

85-160

N/A

N/A

DEPEND Stretch Pants - L

INCK803-50

19803

Unisex

90-110

N/A

N/A

Tena Fix Large

INCT030-25

754030

Unisex

100-120

N/A

N/A

Tena Fix Extra Large

INCW100-1

754031

Unisex

120-140

N/A

N/A

Tena Fix 2X Large

INCT032-25

754032

Unisex

130-180

N/A

N/A

Tena Fix 3X Large

INCT047-25

754047

Booster Inlay

Gender

Waist (cm)

Total Capacity (mL)

Working Capacity (mL)

Sample Required Please Tick

Description

Superior Health Code

Supplier Code

Unisex

N/A

240

N/A

DEPEND Booster Inlay

INCK677-30

19677

Unisex

N/A

N/A

N/A

Tena Duo

INCT907-30

2308907

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