These forms are for healthcare professionals to refer patients to Active Life Medical Products. Thank you for choosing us to help your patients with their catheter, incontinence, and ostomy needs.


  • Accreditation by the Board of Certification (BOC).
  • 25+ years supplying catheters, incontinence, and ostomy supplies.
  • Exceptional service provided by our Product Specialists.
  • Insurance companies are directly contacted for product approvals.
  • Free product samples are offered to help you find the right product.