Libre Support Program

FREE PERSONALIZED TRAINING WITH A CERTIFIED DIABETES EDUCATOR OVER THE PHONE

The Libre Support Program connects patients and caregivers with Certified Diabetes Care and Education Specialists (CDCES) to get started on FreeStyle Libre systems. By filling out this form, a CDCES will call in 1-3 business days. To learn more or get started sooner, call 1-833-855-4273, Monday through Friday, 8AM to 8PM ET, excluding major holidays.

I am a Caregiver and wish to enroll in the Libre Support Program…

* By checking this box, I am confirming that I am over 18 years of age.

Your Personal Information

Caregiver First Name *

Caregiver Last Name *

Your Contact Information

Caregiver Phone *

Caregiver Email

Preferred Communication Time

By checking this box, I agree to receive automated SMS messages from the Libre Support Program relating to Abbott products and services. Consent is not a condition of this program. SMS Terms and Conditions.

Patient Information

Patient's First Name *

Patient's Last Name *

Patient's Date of Birth *

Patient's Zip *

Which FreeStyle Libre systems sensor will the patient be using?*

Non-English Support Requested

Language

*Required to Receive Support:

* By checking this box, I am confirming that I am a legal representative/caregiver for a patient who has been prescribed or will be using an Abbott product and would like to receive additional support for the patient named above. I understand and agree to the Libre Support Program Terms and Conditions.

* By checking this box, I understand and agree that Abbott and its service providers will collect and process my personal information and, agree on behalf of the patient, that the patient's personal information will be collected and processed in accordance with the Abbott Privacy Policy and its Consumer Health Data Privacy Policy; I further understand and agree that Abbott and its contracted service providers may collect and process the patient's Sensitive Data/Consumer Health Data, as defined by applicable laws, including information about my health such as, health conditions, treatments, and/or health related procedures, as necessary to evaluate the patient's eligibility to participate and to enroll me and the patient in the Libre Support Program, which includes providing me as the caregiver (and where appropriate, the patient), with personalized support services and promotional, informational, and non-promotional communications and messaging related to the patient's FreeStyle Libre systems sensors and associated apps.

(Optional) By checking this box, I agree that Abbott may use and process the patient's Sensitive Data/Consumer Health Data to send me non-promotional and promotional communications about other Abbott products and services and/or associated conditions and treatments (in addition to any messaging I may receive as part of the Libre Support Program above) in accordance with the Abbott Privacy Policy and its Consumer Health Data Privacy Policy.

I understand that I can withdraw my consent at any time by calling 1-833-855-4273.

Medicare and other payor criteria may apply.

The FreeStyle Libre 3 system and FreeStyle Libre 2 system are indicated for use in people with diabetes age 4 and older.

FreeStyle Libre 2 Plus sensor and 3 Plus sensor are indicated for use in people with diabetes age 2 and older.

This website and the information contained herein is intended for use by residents of the United States.

This Program is available for patients with Type 1, Type 2, or gestational diabetes and/or caregivers supporting these patients. Patients ages 2-17 are eligible for the Program through their parent or guardian. The Program is not provided as any inducement for future purchases. This Program is void where prohibited by law. Abbott may modify or rescind this Program at any time without notice.

For full Libre Support Program Terms and Conditions, visit getstartedlibresupport.opushealth.com/tandcs.html

Important Safety Information

Product for prescription only, for Important Safety Information please visit FreeStyleLibre.us.

ADC-2661725 v4.0

GET FREE ONE-ON-ONE TRAINING WITH LIBRE SUPPORT

FREE PERSONALIZED TRAINING WITH A CERTIFIED DIABETES EDUCATOR OVER THE PHONE