Eligible Privately Insured Patients can receive a FREE* CONTOUR^®NEXT EZ blood glucose meter with minimum 50-count CONTOUR^®NEXT test strip purchase

Simple to use. Simple to get.

We're committed to helping you simplify your life with diabetes. That is why we made it so simple for you to get your free* CONTOUR^®NEXT EZ meter.

All you have to do is:

Fill out the information below
Click the SUBMIT button
Print your coupon and bring it to your local pharmacy with a prescription from your healthcare provider (or simply have your doctor call in the prescription)
Purchase minimum 50-count CONTOUR^®NEXT test strip at the pharmacy
Get your free* CONTOUR^®NEXT EZ meter

*Limitations and restrictions apply. Limit one meter per person. Void where prohibited by law.

This offer is not valid for participants eligible for prescriptions reimbursed under Medicaid, Medicare drug benefit plan, Tricare of other federal or state health programs.

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Unfortunately we are unable to accept registrations of patients below the age of 13. Please ask a parent or guardian to register on your behalf.

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Checking this box signifies your confirmation to process your request for a free meter. If you provided health-related information about your or your dependent's diabetes, ticking this box also signifies your consent to our collection and processing of your health-related information to provide you with customer service tailored to your needs. You can withdraw your consent at any time.

We would like to send you information about our products, offers and promotions. If you would like to receive this information please indicate your acceptance by ticking the box below. You can unsubscribe at any time.

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Thank you for choosing CONTOUR® NEXT EZ Blood Glucose Meter! Please click the image below to download your coupon.

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This form could not be submitted at this time. Please contact our customer support team at 1-800-348-8100 .

The information brought to you by Ascensia Diabetes Care US Inc. provides general information. It is not intended to be used as medical advice, diagnosis or treatment and should not replace the advice of your Healthcare Provider.

Ascensia, the Ascensia Diabetes Care logo, Contour, No Coding, the No Coding logo, Sip-In Sampling, Second-Chance, the Second-Chance logo and Microlet are trademarks and/or registered trademarks of Ascensia Diabetes Care.

Ascensia Diabetes Care,
5 Wood Hollow Road,
Parsippany,
NJ, 07054
United States
1-800-348-8100

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