Online order form

We recommend using your laptop/ desktop when ordering. Some mobile devices encounter an error when completing the form. If you continue to encounter an error please check your browser settings.

Note: when ticking the two month order box, you must order the supplies you require for two months. The Association does not ‘double your order’. Ticking the box simply allows the system to accept up to two month maximum supply.

By submitting this order, consent is given to ACT & Districts Stoma Association to verify your Medicare
information with Services Australia. You also confirm that all products provided through the
Stoma Appliance Scheme are for own personal use.

Annual Access Fee is due June 30th 2024. Full – $80 Conc. $70

Unless fees are paid by June 30 the Association is NOT permitted to dispense products under the Stoma Appliance Scheme from July 1 onwards. A renewal form will be included with orders or can be emailed on request.

*As of July 1st 2024, postage and handling will increase. $16 per one month order, $22 per two month order.