Please read carefully before proceeding to the form

Only use this form if you are a Tandem pump user whose USB Rubber Door is lost or damaged. For all other issues, please visit our Support page.

For instructions on how to apply a new USB Port Rubber Door on your pump, click here.

USB Rubber Cover

How to use this form

All required fields are marked with a *.

Once you submit the form, your request will be processed within 24 hours. You will receive a confirmation email once your request has been processed. Our technical support team will contact you if we require additional information to process your request.

If applicable, your replacement will be shipped via standard ground shipping.

First Name:

Last Name:

Email Address:

Phone Number:

Date of Birth:

I would like to receive communication via SMS:

Street Address:

City:

State:

Postal Code:

Signature required for delivery:

Enter your Pump’s serial number:

Date USB Port Cover was damaged:

What happened to the USB Port cover?

Are you submitting this form on behalf of another person?

Reporter Name:

Reporter Email:

Reporter Phone Number:

Reporter Street Address:

Reporter City:

Reporter State:

USB Port Rubber Door Service Request

Please read carefully before proceeding to the form

How to use this form

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