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Order Your New OneTouch^® Blood Glucose Meter in 3 Simple Steps

Your health insurance company understands the importance of blood glucose testing. That's why they want you to choose the best meter for you and are pleased to offer you the opportunity to upgrade to a OneTouch^® meter, at absolutely no charge to you.

Dear Valued Customers:

Based on the program in which your plan participates, you will receive either a OneTouch^® voucher for a free of charge meter to be redeemed at your local pharmacy with your new prescription, or a OneTouch^® meter, shipped to your home.

Please complete the information on this page to get started.

Thank you in advance for choosing OneTouch^®, the # 1 meter and test strip brand recommended by doctors!

Step 1: Enter the Brochure Code

Brochure Code:

Don't have a brochure code?

Are you a health care professional?

or	Health Insurance:

This is my first blood glucose meter:
or
Current meter being used:
How long have you had your meter?

Next Step >

Step

Step 2: Select a OneTouch^® meter

Click on the button below the OneTouch^® meter you would like to order.

< Previous Step

Next Step >

Step

Step 2: Confirm your Apple device is compatible with the OneTouch^® Verio^® Sync meter

Do you have an iPhone, iPad or iPod touch running iOS6 or later?

To check which version of iOS you are using on your Apple device simply tap Settings from the Home Screen > General > About

Yes

< Previous Step

Next Step >

Step

Step 3: Patient Information

We are happy to process your request for a OneTouch^® meter. By submitting your information, you agree that it will be governed by our Privacy Policy.

Health Insurance Company:
Meter Selected:
Brochure Code Entered:

Fields with an Asterisk ( * ) are required.

Health Care Professional Information

Office/Practice Name:
Order Code/Office Code:	Your can locate Order Codes on the product brochure sent to the member. Office Codes will have been assigned/designated by the Health Plan.
First Name*:
Last Name*:
Address*:
Apt#/Unit:
City*:
State*:
Zip Code*:
Phone*:	Accepted Format: XXX-XXX-XXXX
Fax*:	Accepted Format: XXX-XXX-XXXX
E-mail:

Fields with an Asterisk ( * ) are required.

Shipping Information

First Name*:	Enter your first name as it appears on your health plan card.
Last Name*:	Enter your last name as it appears on your health plan card.
Address*:
Apt#/Unit:
City*:
State*:
Zip Code*:
Phone*:	Accepted Format: XXX-XXX-XXXX
Mobile Phone:	Accepted Format: XXX-XXX-XXXX
E-mail:	Required for shipping confirmation
Would you like to stay informed? If so, how would you like to receive information? Yes, I would like to receive, via the channels below, diabetes-related information and promotional offers from LifeScan, Inc. I agree that my information will be available to LifeScan, its affiliates and companies that work with LifeScan and that LifeScan may contact me for my opinions related to its business. Select All Email Text^† Phone Mail † Msg & Data Rates May Apply You can unsubscribe by calling 800-227-8862. For more information about OneTouch^® products, visit: https://www.onetouch.com/products.
Yes, I understood that the VerioSync meter will work only on the device identified by the model number provided.

Fields with an Asterisk ( * ) are required.

Diabetes Information

Age*:

How often do you test your blood sugar?*

How do you currently manage your diabetes?*

Diet/Exercise	Insulin shots- 1-2 times per day
Pills	Insulin shots- 3 or more times per day
Insulin pump	Other

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Submit Your Order

Step

Dear OneTouch^® Customer,

Thank you for responding to our offer to receive a OneTouch^® blood glucose meter. Unfortunately, the offer is not intended for people currently using a OneTouch^® Brand meter. We appreciate your continued business.

For more information about diabetes, please visit https://www.onetouch.com.

Return Home

Thank you for selecting a new OneTouch^® blood glucose meter. You will receive your new
or meter voucher within 5 business days.

Your meter or meter voucher will be shipped to:

In order to use your new OneTouch^® meter you will need a new prescription for the from your provider.
The change of your meter and test strip coverage is effective January 1,2016, so you can fill your prescription for OneTouch^® test strips on January 1^st

Please print this page for your records and in any future communication with us quote this reference number:

Please make sure that you ask your doctor for a prescription for . You'll be glad to know that by using your new OneTouch^® meter you could save money on your test strip co-pay.
are covered at the lowest co-pay on your health plan^*.

If you have any questions or problems with the Web site please send an e-mail to the Webmaster (webmaster@dclcorp.com).

If you have any questions once you have received your meter please visit OneTouch.com/Support or call LifeScan's Customer Service, 7 days a week 8 a.m. - 10 p.m. Eastern Time:

800 227-8862 (English)
800 381-7226 (Español)

^* Some health plans may have more than one test strip covered at the lowest co-pay.

Return Home

Dear OneTouch^® Customer,

You have already ordered a similar meter during the last 36 months. If you believe you are receiving this message in error, please call the phone number on the offer letter you received in the mail or call us at 800-227-8862.

Return Home

Dear OneTouch^® Customer,

Unfortunately this meter is currently unavailable at this time.

< Previous Step

Dear OneTouch^® Customer,

Unfortunately this meter is currently unavailable. However, in the interim please choose another meter and as soon as the '' becomes available we will send it to you also.

< Previous Step

The address validation program has suggested an update to the address you entered.
Please Accept the Updated Address, or 'Cancel' to return to the Previous Page.

Address As-Entered	Updated Address

Address 1:	Address 1:
Address 2:	Address 2:
City:	City:
State:	State:
Postal Code:	Postal Code:

		Accept Cancel

We'll be back soon!

Sorry for the inconvenience but we're performing some maintenance at the moment. We'll be back online shortly!

Step 1: Enter the Brochure Code

Step 2: Select a OneTouch® meter

Step 2: Confirm your Apple device is compatible with the OneTouch® Verio® Sync meter

Step 3: Patient Information

Health Care Professional Information

Shipping Information

Diabetes Information

Step 2: Select a OneTouch^® meter

Step 2: Confirm your Apple device is compatible with the OneTouch^® Verio^® Sync meter