Preparation of Skin Barrier/Wafer: 1. Measure your stoma using the measuring guide provided. Select a skin barrier with a flange (white ring) at least 1/2 inch larger than your stoma size. For flush or retracted stomas, convex skin barriers are recommended. Trace the exact same stoma size onto the center white release paper on the back of the skin barrier. 3. Cut along the tracing with a curved scissor. *If using a pre-cut wafer, no cutting necessary. 4. A caulking material, such as Stomahesive Paste or an Eakin Cohesive Seal, can be applied to the back of the skin barrier to further fill gaps between the wafer and the stoma. Allow the paste to set for one minute prior to application to the skin. (Do not spread the paste.) Attachment of Pouch: 1. Before attaching the pouch, allow a small amount of air to enter the pouch by gently separating it. 2. If you are using a SUR-FIT Natura drainable pouch with a clip, for attachment of the tail clip, fold the bottom of the pouch over the tail clip only once. Press firmly on the center of the clip until it snaps securely closed. If you are using a SUR-FIT Natura urostomy drainable pouch with a tap, make sure the tap on the pouch is closed before attaching pouch to wafer. Align the flange on the pouch with the flange on the skin barrier. Press them together beginning at the bottom and circling around the top side of the flange. You will hear several clicks as the system locks into place.