We apologize for the inconvenience, but our web portal is currently unavailable. We appreciate your patience, and we will be back online as soon as possible.
In order to facilitate patient access to enrollment we will use a temporary method until we can reactivate the online enrollment process. Please follow the instructions on the enclosed PDF enrollment form to enroll in the program.
COMPLETE THE APPLICATION (Click here to download the PDF) WITH REQUIRED DOCUMENTATION TO:
| FAX | |
|---|---|
| 833-235-9633 |
Dexcom Patient Assistance Program PO Box 70 Chesterfield, MO 63006 |
Upon receipt of a completed application, you will be notified of your eligibility for the Dexcom Patient Assistance Program. If you are eligible for assistance, Dexcom CGM supplies will be shipped to the mailing address Dexcom has on file for you.
Submission of an application does not guarantee eligibility for the Dexcom Patient Assistance Program. All applications must be reviewed before eligibility can be determined. This program may be modified or discontinued by Dexcom at any time.
Thank you,
Dexcom Patient Assistance Program
Hours of Operation: Monday through Friday, 9:00am ET – 6:00pm ET
Telephone: 1-833-235-9634