Medtronic Diabetes eShop - Account Request

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Create Account| User Information

Pump User Details

Title
*First Name
Middle Name
*Last Name
*Date of Birth (DD/MM/YYYY)

Phone *Home or Mobile phone - Required

Home/Work Phone: Please enter as xxx-xxx-xxxx (for example – 416-232-0167)
Mobile PhonePlease enter as xxx-xxx-xxxx (for example – 416-232-0167)

Residential Address An additional delivery address can be added once your account is activated.

*Number & Street Name
*Postal Code
*Province
*City

Pump Details

Please provide the serial number of the device
Medtronic Serial Numbers are found in this format: XXX000000X (3 alphabetic characters + 6 numeric characters + 1 alphabetic character).

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