Acknowledgement Form

Field Safety Notice for X.6 Software Launch

It is important you acknowledge receipt of the field correction notice by completing this form.

At Tandem Diabetes Care, patient safety is our top priority, and we are committed to delivering safe and effective therapies of the highest possible quality and reliability. We appreciate your time and attention in reading this important notification.

For more information, see the t:slim X2 insulin pump letter

For written and video instructions on how to update your t:slim X2 insulin pump, click here.

Thank you for being a part of the Tandem family.

Sincerely,

Tandem Diabetes Care

First Name (of person using pump):

Last Name (of person using pump):

Email Address:

Serial Number:

Check this box to acknowledge additional Tandem customers in your household:

First Name(s) (of person using pump):

Last Name(s) (of person using pump):

Serial Number:

Creating New Possibilities

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nullam luctus felis nibh, quis pharetra odio fermentum sed. Sed ac aliquet elit. Morbi ultrices pretium tempor. In id nisl rutrum, imperdiet dui at, dictum diam. Etiam pellentesque sollicitudin nibh, a pellentesque quam suscipit vitae. Suspendisse pulvinar, lorem id pellentesque aliquet, mauris risus blandit purus, sed suscipit erat felis vitae enim.