Orders for the current month must be received by the second last business day of that month
Download PDF Order Online NowThe below forms are strictly for use by a Registered Stomal Therapy Nurse ONLY! Members are not permitted to submit these forms. Member who submit any of the below forms will have their order cancelled and will need to resubmit their order again with the correct form.
To be completed by Medical Officers and Stomal Therapy Nurses
To be completed by Medical Officers and Stomal Therapy Nurses
To be completed by Medical Officers and Stomal Therapy Nurses
Download PDFTo be completed by Medical Officers and Stomal Therapy Nurses
Download PDFTo be completed by Medical Officers and Stomal Therapy Nurses
Download PDFTo be completed by Medical Officers and Stomal Therapy Nurses
Download PDFUse this form to apply for access to Peristeen Plus on the Stoma Appliance Scheme. This form should be completed by the applicant or their authorised representative as well as the applicant’s authorised health professional.
Download PDFUse this form to apply for additional supplies under the Stoma Appliance Scheme (SAS) for more than 2 months’ supply and up to 6 months’ supply, if you are:
Orders may be submitted by email to [email protected] using the order form linked above.
Please include your membership number, name, address, item numbers and quantities of the products you require and indicate if the order is to be shipped or collected from the distribution centre.
Alternatively the orders can be posted to
Postal Address: PO Box 79 Torrensville Plaza SA 5031
Please allow 14 days for processing and delivery.
You may complete these forms either digitally or manually.
Once the PDF form(s) has been completed you can return back to us via: