CGM Reorder Form

Please fill out this form to receive uninterrupted timely delivery of your CGM supplies. The more information you provide, the easier it is to process your enrollment. The required fields are listed with a red asterisk (*). If you have any questions please call our Customer Service Department at 1-888-246-7667.

* As part of the requirements for obtaining CGM testing supplies every six (6) months following the initial prescription of the CGM, the treating practitioner has an in-person visit with the beneficiary to assess adherence to their CGM regimen and diabetes treatment plan. Chart notes from this visit are required to remain eligible for CGM supplies.

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