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Diaper Request Form

Information

Special Needs Essentials carries a variety of youth diapers, adult diapers, adult liners, bariatric diapers, underpads, swimming disposable briefs and related incontinence products in a variety of sizes and styles. All of these disposable briefs and liners are made from one of the top diaper manufacturers providing the best quality of fit and protection for you or your loved one.

Incontinence can be difficult and embarrassing for some. With the discreet design of each diaper, you can confidently achieve tasks and activities throughout the day and night. 

Try a free sample today. You will receive two of whichever disposable brief you prefer. Just simply fill out the form on the right with your choice and delivery address in the message form. 

Don't want to fill out the form? No problem...

Call us @ (302) 497-7136 

 Rules: 

  • One sample request per household.
  • Limited to the United States ONLY. 
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