Stoma Appliance Scheme – Irrigation kit authorisation form

Authorised health professionals can sign this form to authorise a patient to order an irrigation kit from their stoma association. A relevant surgeon must also be consulted to confirm that the irrigation kit is appropriate for the patient.

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Patients must be assessed by an authorised health professional’.

Stoma Appliance Scheme – Irrigation kit authorisation form

Save a copy by right-clicking on the download link and saving to your computer. Open the file and then fill in the details.

About this resource

Publication date:
Publication type:
Form
Audience:
General public
Language:
English

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