Altiform^® Made to Measure Repeat Orders

Download Altiform® Made to Measure Order Form (PDF)

BRITISH STANDARD COMPRESSION HOSIERY AVAILABLE ON DRUG TARIFF FP10/GP10

It is essential that all required fields are completed fully; otherwise your order cannot be processed.

Privacy Statement
In compliance with GDPR, you can access our updated privacy notice for healthcare professionals and patients.
We process your personal data to allow us to answer your request submitted in this form. Should you require any further information, please consult our Privacy Policy.
By submitting this form you authorise us to process the information for promotional, commercial and/or scientific purposes. We will not transfer that information to companies outside of the Urgo group for commercial purposes. (Should you require further information, please consult our Privacy Policy).