ENROLL TODAY TO RECEIVE ONE-ON-ONE SUPPORT!

* By checking this box, I represent and warrant that I have received all necessary permission and consent from the patient whose health information I am submitting via this form to Abbott and its affiliates and service providers, that complies with state and federal law and that informs the patient of their rights and obtains their permission for Abbott and its affiliates and service providers to use and disclose the PHI and Sensitive Data/Consumer Health Information of the patient to enroll the patient in the Libre Support Program and to administer the Program.

By submitting this form, I agree that Abbott may send me non-promotional communications, informational and promotional email about Abbott products and services and/or associated conditions and treatments in accordance with the Abbott Privacy Policy and Terms and Conditions. I understand that I can withdraw my consent at any time by calling 1-833-855-4273.

Medicare and other payor criteria may apply.

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 4-17 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

^The FreeStyle Libre systems apps are only compatible with certain mobile devices and operating systems. Please check the Support section of our website for more information about device compatibility before using the apps. Use of the FreeStyle Libre systems apps may require registration with LibreView.

Important Safety Information

FreeStyle Libre 2 and FreeStyle Libre 3 systems: Failure to use FreeStyle Libre 2 or FreeStyle Libre 3 systems as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If glucose alarms and readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at 855-632-8658 or FreeStyleLibre.us for safety info.

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