Enroll Your Patient in me+™

Provide your patients with an additional layer of support and care when you sign them up for me+.

me+™ can help nurses and other healthcare professionals surround patients with the education, support and resources they need to feel empowered throughout their cathing journey. Our program is designed and customized to guide the right support at the right time.

Have questions? Contact the me+™ support team at 1-800-422-8811 or email GC-US@convatec.com.

Step 1 of 2 - Patient Details

First Name *

Last Name *

Email *

Telephone *

Telephone Type

Select Your Country * United States

Retailer

Catheter Size

Catheter Type

Special Instructions

* You and your patient's privacy is important to us. By submitting both your patients and your information, you both agree to Convatec's Privacy Policy and Health Information Consent Policy. If the patient would like to order Convatec's products, they authorize Convatec to identify and transfer them to a designated Convatec retailer.*

* By submitting this request, you confirm that (1) the Customer has authorized the disclosure of the requested personal information; (2) the Customer has requested that you submit this form on his or her behalf; (3) the Customer has agreed to the Convatec Privacy Statement; and (4) the Customer has agreed to the Authorization Transfer provision.*

You and your patient authorize Convatec to call, email, text or mail you information about Convatec's products and services. You or your patient may withdraw this authorization by contacting us at 1-800-422-8811, GC-US@convatec.com, or by mail at PO Box 270603, Oklahoma City, OK 73137.

Step 2 of 2 - Your Details

First Name *

Last Name *

Email *

Telephone *

Facility Name *

Facility Zip Code *

Remember my details for next time

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