Edit, Download, and Sign the Hollister Secure Start Service Consent Form
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How do I fill this out?
Filling out this form is easy and straightforward. Begin by providing your contact information and surgery details. Complete the form with your product preferences and consent statement.
How to fill out the Hollister Secure Start Service Consent Form?
1
Provide your contact information.
2
Enter your surgery details.
3
Select your stoma type and product preferences.
4
Agree to the privacy statement and consent.
5
Submit the completed form to Hollister.
Who needs the Hollister Secure Start Service Consent Form?
1
Ostomy patients needing long-term support services.
2
Healthcare providers assisting patients with ostomies.
3
Individuals seeking product samples and recommendations.
4
Nurses monitoring the progress of their patients with ostomies.
5
Patients requiring assistance in identifying product supplier options.
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How do I edit the Hollister Secure Start Service Consent Form online?
You can now edit the Secure Start Service Consent Form on PrintFriendly. Easily update your personal information, surgery details, and product preferences. Make any necessary changes and save your edited form.
1
Upload the Secure Start Service Consent Form to PrintFriendly.
2
Click on the text fields to enter or update your information.
3
Make necessary adjustments to your surgery details and product preferences.
4
Add your digital signature in the designated area.
5
Save and download the edited form for submission.
What are the instructions for submitting this form?
To submit this form, you can scan and email it to priority@hollister.com.au. Alternatively, you can contact Hollister Customer Care at 1800 880 851 for further instructions. Ensure all fields are completed and accurate for timely processing. My advice: double-check all entered information before submission to avoid any delays.
What are the important dates for this form in 2024 and 2025?
This form does not specify any important dates for 2024 or 2025.
What is the purpose of this form?
The purpose of the Hollister Secure Start Service Consent Form is to provide ongoing support for individuals living with an ostomy. By completing this form, patients can receive personalized guidance and product recommendations tailored to their needs. The form collects essential information such as contact details, surgery specifics, and product preferences to facilitate the provision of comprehensive support services.
Tell me about this form and its components and fields line-by-line.
- 1. Contact Information: Includes fields for title, first name, surname, address, suburb, postcode, email address, date of birth, and phone number.
- 2. Surgery Details: Includes fields for surgery date, discharge date, stoma type, and hospital details.
- 3. Product Preferences: Includes fields for selecting the type of product, barrier, pouch, and manufacturer details.
- 4. Consent Statement: Includes a privacy statement and consent to enroll in the Secure Start Service, requiring a signature and date.
What happens if I fail to submit this form?
Failure to submit this form may result in not receiving the comprehensive support offered by the Secure Start Service. Ensure timely submission to benefit from the program.
- Lack of Support: Patients may not receive the necessary guidance and assistance for their ostomy needs.
- Product Recommendations: Patients may miss out on personalized product recommendations and samples.
How do I know when to use this form?
- 1. Post-Surgery: Use this form after undergoing ostomy surgery to receive ongoing support.
- 2. Product Selection: Fill out this form to get recommendations for the most suitable products.
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Yes, you can edit your personal information by clicking on the respective fields and entering the updated information.
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Is it possible to update my surgery details on the form?
Yes, you can update your surgery details by editing the relevant fields on the form.
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