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940M13758-016 20170306

©2017 Medtronic MiniMed, Inc. All rights reserved.

MiniMed® Pro-set® Infusion Set
Replacement Request Form

To return any unused MiniMed® Pro-set® infusion sets, please complete the form below. Your infusion sets will be replaced for free with another Medtronic infusion set of your choice.



    I am at least 13 years of age or older.*

    Yes 
    No 


    STEP 1:

    Tell us how many affected MiniMed® Pro-set® infusion sets you have on hand.

    From the list below, locate your infusion set model number and enter how many full boxes and additional, individual infusion sets you have. (required)*:

    Model Number Number of Full Boxes
    (Boxes of 10)
    Individual Infusion Sets
    MMT-280
    MMT-281
    MMT-290
    MMT-291


    STEP 2:

    From the table below, please choose what replacement infusion set you would like.

    Important: If you don't see the infusion set that you would like in the table below, please call 1-800-646-4633 ext. 21063.

    Infusion Set Model Description (cannula length, tubing length, connector) Select
    MiniMed® Quick-set® MMT-399 6 mm
    23” Tubing
    Soft cannula
    MiniMed (P-cap) connector
    MMT-398 6 mm
    43” Tubing
    Soft cannula
    MiniMed (P-cap) connector
    MMT-393 6 mm
    23” Tubing
    Soft cannula
    Luer Lock Connector
    MiniMed® Mio® MMT-923 6 mm
    23” Tubing
    Soft cannula
    Pink
    MiniMed (P-cap) connector
    MMT-943 6 mm
    23” Tubing
    Soft cannula
    Blue
    MiniMed (P-cap) connector
    MiniMed® Silhouette® MMT-381 13 mm
    23” Tubing
    Soft cannula
    MiniMed (P-cap) connector
    MMT-382 13 mm
    43” Tubing
    Soft cannula
    MiniMed (P-cap) connector
    MMT-373 17 mm
    23” Tubing
    Soft Cannula
    Luer Lock Connector
    MiniMed® Sure-T® MMT-864 6 mm
    23” Tubing
    Steel Cannula
    MiniMed (P-cap) connector
    MMT-866 6 mm
    32” Tubing
    Steel Cannula
    MiniMed (P-cap) connector
    MMT-863 6 mm
    23” Tubing
    Steel Cannula
    Luer Lock Connector


    STEP 3:

    *
    *
    *
    *
    *

    *
    *
    *
     (MM/DD/YYYY)*
    *
    How do I find this?




    MiniMed, Mio, Pro-set, Quick-set, Sure-T, and Silhouette are trademarks of Medtronic MiniMed Inc.
    940M16235-01120170105 ©2017 Medtronic MiniMed, Inc. All Rights Reserved.

    Pump Serial Number Location

    The serial number is located on the back of the your insulin pump.

    Your serial number will be a series of numbers and letters after the "SN".

    MiniMed 530G

    MiniMed 630G

    If you would like to return any unused MiniMed Pro-set infusion sets, we will be happy to replace them for free. Please call us at 866-222-7304.