ORDER A SAMPLE

Please fill in your details below for your free TENA® sample. US residents only.
( * indicates required fields)

First Name * Last Name *  
         
Street Address * City *  
         
State * Zip Code *  
     
Telephone Number Email Address  
     
Year of Birth of User Gender of User  
 
Who is the Sample For ?  *     
The Degree of User's Bladder Leakage  *     
Please select the sample you would like to receive: *   
When I buy products specifically made for bladder leakage
What products do you currently use (select the product you use most often)
Which brands do you currently use? (select the brand you use most often)
How many bladder leakage pads and/or underwear do you use in a single day?
How did you hear about TENA®?
Please answer the following questions either 'Yes' or 'No' (Y or N)
 Y   N  I've had to adjust my daily activities because of my bladder leakage problem
 Y   N  I am very concerned that someone will find out about my bladder leakage problem
 Y   N  I feel in control of my bladder leakage problem
 Y   N  Bladder leakage is more a sign of old age or sickness
 Y   N  My bladder leakage problem is only temporary.
Contact Preferences:
I would be interested in receiving future information and offers from TENA®, as well as information on home delivery options.
I would like to be contacted to participate in a survey.
I would like to be contacted to participate in a focus group.

Offer good while supplies last. Please allow 4-6 weeks for shipping. Void where prohibited or restricted by law. Limit 1 sample pack per household. No group or organization requests will be honored. Samples are not for commercial use. Commercial use of product will result in legal action. Offer may not be published elsewhere withough permission from SCA PERSONAL CARE. Offer good only in the USA.

The information collected by SCA PERSONAL CARE will be used to administer this sampling offer and you may receive TENA® products and special promotional information via e-mail and U.S. Postal mail from time to time.

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Found in aisles where bladder control products are sold. Consult your doctor about bladder control problems. TENA® and Serenity® are registered trademarks of SCA Hygiene Products.