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Permission to Use Company Works

Frequently Coloplast receives requests from physicians and practices for permission to use our images in their materials. Before Coloplast grants permission and sends the image to the physician or practice, the following steps must be completed. They are:

  1. Download the Permission to Use Company Works Form
  2. Fill out the current date and the name and address of the person/company requesting the use of Coloplast’s works on page 1 of the form.
  3. Fill out Exhibit A with the specific works or trademarks that will be used from Coloplast, list the specific image or description of what image they are looking for. (e.g. Titan product shot, Titan illustration for patients, etc.)
  4. Fill out Exhibit B with the specific information about where Coloplast’s works will be used. (e.g. will it be used in a book, website, magazine, etc.)
  5. Have the Requestor sign and date on page 3 of the form.
  6. Return form to Interventional Urology Marketing Department ( for approval and to be processed.
  7. The Interventional Urology Marketing Department will notify you within approximately 7 days after receiving the signed agreement if the agreement has been approved or not, and to provide you with the requested materials.

If you have any questions please contact Courtney Walter at