Free Meter for Juicebox Listeners

^*Required

Age Verification

Email Address*

First Name*

Last Name*

Phone Number

Please note that we do not ship to PO boxes. Make sure to provide a valid street address to receive your free CONTOUR^® meter.

Address Line 1*

Address Line 2

City*

State*

Zip*

Checking this box signifies your confirmation to process your request for a free meter and confirms that you are a privately insured patient, not eligible to receive health benefits under a government healthcare program. If you provide information about you or your dependents diabetes, checking this box signifies you consent to our collection and processing of your health-related information to provide you with customer service tailored to your needs. You can withdraw your consent at any time.

Your acceptance of this free meter for use as an aid in monitoring the effectiveness of a diabetes control program does not obligate you to any future purchase or referring others to use this product.

We would like to send you information about our products, offers and promotions. If you would like to receive this information please indicate your acceptance by checking this box. You can unsubscribe at any time.

I am happy to receive information from Ascensia by email

Thank You

Your submission has been successfully received.

Important Notice: Orders cannot be shipped to P.O. Box addresses. Please have in mind that requests with P.O. Box addresses will not be processed.

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This form could not be submitted at this time. Please contact our customer support team at 1-800-348-8100.

^* Check with your insurance company as insurers may offer a lower cost option.

1. CONTOUR^®NEXT BGMS User Guide, Rev. 03/21.

Ascensia Diabetes Care
5 Wood Hollow Road
Parsippany
NJ 07054
United States
1-800-348-8100 (CONTOUR Blood Glucose Monitoring)
1-844-736-7348 (Eversense Continuous Glucose Monitoring)