TENA® Sampling

To receive your free sample, just fill in a few questions about yourself and the products you use, then click submit at the bottom of the page. Please allow 4 - 6 weeks for shipping.

If you are under 18, please have your parents or legal guardian submit this form to us. We are not allowed to collect information from or respond to messages sent by persons under 18.

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Telephone Number:

E-mail Address:

Who is this sample for?

Year of Birth of User:

Gender of User:

Degree of leakage of User:

Please select the sample you would like to receive:

TENA®
Pantiliners
Pads
Overnight Protection Pads
Guards for Men

TENA® Underwear
Small/Medium (36"-42" Hips)
Large (42"-52" Hips)
Extra Large (52" + Hips)

What products do you currently use?

	Belted Undergarments
	Bladder Leakage Pads
	Bladder Leakage Liners
	Disposable Underwear
	Feminine Hygiene Products
	Maxipads/Regular Maxis

	Nothing
	Pantiliners
	Protective Underwear
	Ultra Thin Maxis
	Undergarments/Briefs

What brands do you currently use?

	Alldays
	Always
	Carefree
	Compose
	DEPEND^®

	DEPEND^® Guards for Men
	Kotex
	Lightdays
	Other

	Poise
	TENA^®
	Stayfree
	Store Brand

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 Offer may not be published elsewhere without written permission from SCA PERSONAL CARE.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® product and special promotional information via e-mail and U.S. Postal mail from time to time.

		I would be interested in receiving future information and offers from TENA®, as well as information on home delivery options.
		May we contact you to participate in a survey.
		May we contact you to participate in a focus group.

SCA PERSONAL CARE