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Health and Product Questionnaire

Click here to download this form, which is required as part of the process to purchase a new insulin pump.

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Articles in this section

  • Health and Product Questionnaire
  • Statement of Medical Necessity
  • Patient Information Form (PIF) / Assignment of Benefits (AOB)
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Product Support New Customer Support Diabetes Resources

Need help with your Dexcom CGM?

Tandem handles issues with the connection between your Dexcom transmitter and t:slim X2 pump, questions about calibration, the “---” display, and sensor failures after the 2-hour warmup period. To report a sensor failure after the 2-hour warmup period, visit tandemdiabetes.com/G6Form

For all other CGM issues, including sensor failures during the 2-hour warmup, “no restarts” alert, or physical problems with your sensor or transmitter, such as bleeding, bruising, skin reaction, adhesive issues, applicator issues, or broken wires, you should contact Dexcom using one of the options at dexcom.com/contact.

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