As a Healthcare provider, you have RECOMMENDED SIMPLE to your patients
This webform is strictly for use by diabetes healthcare providers and patients who have received a referral from them.
After submitting the form, patients will receive a Starter Kit1 including an Accu-Chek Guide system and a silicone case. In order to provide them with the maximum experience, your patient will receive tracking alerts from FedEx by email.
Patients will also obtain more information from us on diabetes, our promotions and our products.
If you have any problems ordering, please contact us for assistance 1-800-363-7949.
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Read our Personal Information Policy
1 PLEASE NOTE: Limit of one (1) offer per person for a period of 12 months; Additional requests will not be processed. This offer is conditional upon availability on inventory and is subject to change, substitution or termination at any time the sole discretion of Roche Diabetes Care.
The silicone case only fits the Accu-Chek Guide meter. Limit of one (1) offer per person while quantities last. Colours may vary from the images shown and if an item runs out of stock after your order is placed, we will select the next available colour.