Request a sample

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* By ticking the box and clicking on "Continue", I confirm that I have been medically diagnosed with a type of diabetes and agree to the Sampling Programme Terms & Conditions of participation.

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* I confirm that I am 18 years of age or older, or that I am a parent/guardian entering on behalf of a child with diabetes aged 2 – 18.

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* I understand that by participating in the Dexcom sample program my personal information will be processed in accordance with our Privacy Policy and Sampling Programme Terms and Conditions.

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* I have checked that my smart phone is compatible with the Dexcom ONE+ app. Please note you will not be able to use the sensor if your phone isn’t compatible.
Check your phone’s compatibility here.

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Tell us a little about yourself!
Please indicate below the personal details of the person who will be using the Dexcom CGM system, whether yourself or a dependent (child, relative, etc.).

Who are you submitting the form for?*
The Dexcom user's name and date of birth must be provided to checkout.

Myself.

My dependent.

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First Name*

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Last Name*

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Email*

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Confirm Email Address*

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Guardian First Name*

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Guardian Last Name*

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Ex. DD/MM/YYYY

Date of Birth*

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Phone Number*

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Street Address*

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Town/City*

Select an address from the 'Street Address' drop-down menu.

Postcode*

Select an address from the 'Street Address' drop-down menu.

Country*

How do you currently keep track of blood sugar levels?*

A Continuous Glucose Monitoring (CGM) System

Fingersticks / Blood Glucose Monitor

Neither

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What CGM manufacturer are you currently using?*

FreeStyle Libre (Abbott)

Medtronic

Dexcom

Other

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What type of diabetes have you been diagnosed with and what does your current treatment look like?*

I wish to receive updates with tailored offers and news about Dexcom products. I can opt out of these communications at any time by contacting privacy@dexcom.com. Dexcom respects the privacy and confidentiality of your personal information. We will not share your personal information with any third-parties, except as otherwise noted in our Privacy Policy.

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Where did you first hear about the Dexcom ONE+ sample programme?*

GP or practice nurse.

Endocrinologist.

Diabetes consultant/consultant diabetologist.

Diabetes specialist nurse.

Pharmacist.

Another healthcare professional.

Friend, family member or someone else with diabetes.

Dexcom website.

Diabetes charity, website, podcast, blog or article.

Social media.

TV advert.

Google or other search engine.

Online advert.

Email from Dexcom.

Event.

Other.

What helped you decide to request a sample today?*

I saw or heard an advert that made me interested.

A healthcare professional recommended it.

Someone I know recommended it.

I wanted to try CGM for the first time.

I wanted to compare Dexcom with my current sensor.

I wanted to see whether Dexcom ONE+ fits into my daily routine.

I was looking for better support with my glucose levels.

I was interested in the alerts.

I was interested in sharing my glucose data with others.

Other.

What are you currently using to check your glucose levels?*

Finger-prick blood glucose meter.

FreeStyle Libre 2.

FreeStyle Libre 3.

Dexcom G7.

Dexcom G6.

Medtronic Guardian.

Eversense.

Medtrum.

GlucoMen Day.

Accu-Chek SmartGuide.

Another sensor or glucose monitoring device.

I am not currently using a glucose monitoring device.

Not sure.

What do you hope to get from your sample?*

To learn the basics of using CGM.

To see whether Dexcom ONE+ fits into my everyday life.

To understand my glucose patterns more clearly.

To feel more confident managing my diabetes.

To decide whether I want to continue using Dexcom ONE+.

To help me have a conversation with my healthcare team.

Other.

What are you most interested in trying with Dexcom ONE+?* Choose up to two

Seeing your glucose levels without routine finger pricks.

Alerts that can warn you about highs or lows.

Understanding how food, activity or routine affects your glucose.

Seeing trends and patterns in your glucose levels.

Sharing your glucose data with family, carers or your healthcare team.

Wearing the sensor in different places on your body.

Connecting Dexcom ONE+ with your phone or smartwatch.

Trying a smaller or more comfortable sensor.

Wearing the sensor while showering or swimming.

Seeing my glucose levels throughout the day and night.

Something else.

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