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By requesting contact with a MiniMed Ambassador to discuss questions or issues regarding insulin pump therapy and/or continuous glucose monitoring, I hereby authorize Medtronic Diabetes to forward my personal message and the contact information I provide to the MiniMed Ambassador selected by me and/or Medtronic Diabetes, as applicable. I understand that throughout the course of communicating with the MiniMed Ambassador that we may decide to make contact through other channels of communication such as phone and/or Skype. Additionally, I understand that the thoughts, opinions, or information provided to me by the ambassador may not be those of Medtronic Diabetes. I understand I may stop communications at any time by informing the ambassador or Medtronic Diabetes (ambassador@medtronic.com). (NOTE: This program for communicating with MiniMed Ambassadors is only available for residents of the United States.)

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