DIABETES TAKES
NO BREAKS.

NEITHER DO WE.

ALWAYS BY
YOUR SIDE^SM.

AUTHORIZATION FOR USE OF PROTECTED HEALTH INFORMATION

You authorize Medtronic MiniMed, Inc. d/b/a Medtronic Diabetes or its subsidiaries, contractors or representatives to use your personal information, including but not limited to your contact information and health information, for marketing purposes and to share that information with Medtronic representatives and contractors. Information you may receive includes, but is not limited to: (a) Medtronic Diabetes products, therapies or services; (b) marketing and promotional offers; (c) inquiries about your experience with Medtronic Diabetes products, therapies and services; and/or (d) suggestions for how Medtronic Diabetes can enhance its customer support.

This authorization will expire three (3) years from the later of the date you submit this authorization online; or (ii) the last date products or services were received from Medtronic, but may expire sooner if you revoke it by following the instructions below.

You have the right to revoke this authorization at any time by (i) e-mailing takecontrol@medtronic.com; or (ii) signing into your myHome profile and updating my communication preferences at www.diabetes.shop/myhome. A revocation will not affect actions Medtronic Diabetes has already taken based on this authorization. Information disclosed pursuant to this authorization may be re-disclosed by the recipient of the information and may no longer be protected by the federal privacy standards.

You have the right to refuse to sign this authorization. Refusal to sign will not affect your treatment or health insurance eligibility or benefits.

Questions? Contact our Customer Service Center at 800-646-4633, or by email at takecontrol@medtronic.com.

Close

CONSENT FOR RECEIPT OF PHONE COMMUNICATIONS

You consent to receiving phone calls, including pre-recorded and auto-dialed communications, at the phone number(s) submitted above using automated technology from or on behalf of Medtronic MiniMed, Inc. d/b/a Medtronic Diabetes, concerning the marketing, advertising and/or offers of sale of Medtronic Diabetes products, therapies and services. You also certify that you are (a) age 18 and older and (b) authorizing and consenting to use of the information provided for Medtronic Diabetes to contact you. Your consent is not a condition for purchase. Airtime, message and data rates may apply. You may opt out at any time by (i) e-mailing takecontrol@medtronic.com; or (ii) signing into your myHome profile and updating your communication preferences (www.diabetes.shop/myhome).

Close

CONSENT FOR RECEIPT OF TEXT COMMUNICATIONS

You consent to receiving text messages at the phone number(s) submitted above using automated technology from or on behalf of Medtronic MiniMed, Inc. d/b/a Medtronic Diabetes, concerning the marketing, advertising and/or offers of sale of Medtronic Diabetes products, therapies and services. You also certify that you are (a) age 18 and older and (b) authorizing and consenting to use of the information provided for Medtronic Diabetes to contact you. Your consent is not a condition for purchase. Airtime, message and data rates may apply. You may opt out at any time by (i) texting "STOP" in return to a text; (ii) sending an email to takecontrol@medtronic.com; or (iii) signing into your myHome profile and updating your communication preferences (www.diabetes.shop/myhome).

Close