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Accu-Chek FastClix - Delivery Form

Thank you for choosing the Accu-Chek Guide System.  Take advantage of this EXCLUSIVE offer!

Order your FREE Accu-Chek FastClix and obtain more information from us on diabetes, our products and our promotions.

Your Accu-Chek Guide SERIAL NUMBER is required below.  It can be found on the back of your meter.  Show me where