Sensor Support Form

Sensitive Data Consent

I understand and agree that Abbott will process my sensitive data (i.e., medical history, mental or physical health condition, or medical treatment or diagnosis by a health care professional) in order to report my sensor issues and send me a replacement sensor. You can view our third parties and third-party advertisers, under “Advertising Cookies” through the Your Privacy Choices link in the footer of this website. Residents of certain states can withdraw consent by clicking here.

♢ Eligible patients will receive one (1) FreeStyle Libre 2 sensor or (1) FreeStyle Libre 3 sensor for users with a compatible mobile phone operating system at $0 copay. The expiration date of the voucher is 60 days from the issue date. This program is available for patients with Type 1, Type 2, or gestational diabetes. Patients ages 18 and older are eligible to sign up and receive an offer for the (1) FreeStyle Libre 2 sensor or (1) FreeStyle Libre 3 sensor. Patients ages 4-17 are eligible to receive an offer for the (1) FreeStyle Libre 2 sensor or (1) FreeStyle Libre 3 sensor through their parent or guardian. This offer is void where prohibited by law. Abbott may modify or rescind this offer at any time without notice. The discounts are not available to beneficiaries of Kaiser Permanente, Medicare, Medicaid or other federal or state healthcare programs, residents of Massachusetts, or US territories (other than Puerto Rico). The free (1) FreeStyle Libre 2 sensor or (1) FreeStyle Libre 3 sensor is provided as a sample and is limited to one sample per eligible person per product identification number. The FreeStyle Libre 2 sensor or FreeStyle Libre 3 sensor cannot be re-sold, traded nor submitted to any third-party payer for reimbursement and is not provided as any inducement for future purchases. The free sample card is not health insurance.

ADC-67159 v2.0 07/23