Whether you're ready for a new pump, or you're just looking to check your insurance coverage, everything you need to get started is right here.
Complete this form to check your insurance benefits and start the process to get your new Tandem insulin pump.
I WANT A PUMP!
Complete this form to authorize us to contact your insurance provider to help determine coverage for a new Tandem pump.
CHECK MY COVERAGE!
These forms provide us with contact information for you, your healthcare provider, and your insurance company and gives us permission to contact them on your behalf to determine your benefits. Please note, if you leave the forms before you complete the signature process, your data will be lost and you'll need to start over. Need assistance? Give us a call at (877) 801-6901. Our Pump Specialists are available Monday - Friday from 6:00am to 5:00pm Pacific Time.
We will contact you within two business days to confirm your information, prior to contacting your insurance company. When you are ready for a Tandem insulin pump, we will also work with your healthcare provider to complete the proper paperwork. A Tandem representative will contact you regularly with status updates.
If you prefer not to submit your information through the online form above, getting started is still simple. Just follow the instructions below to mail or fax your information to us. Or you can always call us and we can take your information over the phone. Our Pump Specialists are here from 6am to 5pm Pacific Time, Monday through Friday.
The "Patient Information/AOB" form provides us with contact information for you, your healthcare provider, and your insurance company. It also grants Tandem Diabetes Care, and our authorized distributors or agents, your written permission to contact them on your behalf.
Patient Information/AOB Form
Health and Product Questionnaire
Return forms by mail:
ATTN: Customer Sales SupportTandem Diabetes Care11045 Roselle StreetSan Diego, CA 92121
Return forms by fax:
SECURE FAX(855) 875-4648
IMPORTANT SAFETY INFORMATION