error fb Gplus IN twitter down-arrow Email Phone Check-Mark padlock circle_arrow minus plus play_btn close Clipboard_Icon Shopping-Cart_Icon Speech_Bubble_Icon Stethoscope_Icon pharmacists menu left-arrow right-arrow facebook search cart
Go Back
Order
Please fill out the information below to help us determine if the Dexcom CGM is right for you or your loved one. A customer representative will follow up with you to process a full insurance benefits check after reviewing your information. If you have Kaiser Insurance, please contact your provider for more details.

All fields marked with an asterisk (*) are required. All the information you provide is sent securely.

Personal Information

Therapy Coverage Information

By submitting this form, you agree to the Dexcom Terms of Use and Privacy Policy, and agree that we may use information you provide us to communicate with you in accordance with those terms.

In addition, by checking the applicable box(es) below, you are agreeing to receive at the phone number set forth above, automated phone call and/or text communications, including pre-recorded and auto-dialed communications from or on behalf of Dexcom, Inc. ("Dexcom") concerning the marketing and sale of Dexcom’s products and services: you certify that a) you are the account holder and consent to enroll or have the account holder's consent to enroll and b) you are age 18 or older. Your service provider's airtime, message, and data rates may apply. Your consent is not required for purchase. You may opt out at any time by texting "STOP" in return to a text, or by calling Dexcom at 888-738-3646.

"Dexcom does give me confidence to do whatever I want, go wherever I want and be the person that I am."
- Dexcom warrior, Stephanie – T1D
Have Questions?
Our customer support representatives are available to help answer your questions at 888-738-3646.

How does Continuous Glucose Monitoring work?

Continuous glucose monitoring (CGM) is an FDA-approved system that can help you reach your glycemic goals without an increased risk of hypoglycemia.1 While meters give a number for a single point in time, CGM provides dynamic glucose information by showing where glucose is, where it’s going, and how fast it’s getting there*.

Dexcom G5 Mobile CGM consists of 3 parts:1

Small Sensor that measures glucose levels just underneath the skin.
Transmitter that is fastened on top of the sensor and sends data wirelessly to the receiver.
A Display Device which can be a compatible smart device with the Dexcom G5 Mobile app OR the Dexcom G5 Mobile Receiver. Either choice of display will show your glucose trends in vivid colors so you can easily see when it’s high, low or within range.
Smart Device not included with the Dexcom G5 Mobile CGM System

How does the Dexcom G5® Mobile CGM with ShareTM work?

Dexcom Share Information

CGM data is sent from your G5® Mobile transmitter to your compatible device.

Your compatible device sends your glucose information to the Cloud via Bluetooth

The Cloud sends Dexcom CGM data to the compatible device of up to 5 Followers.

* The Dexcom G4 PLATINUM System does not replace a blood glucose meter. Always use the values from your blood glucose meter for treatment decisions.

  1. Dexcom G4 PLATINUM Continuous Glucose Monitoring System Receiver with Share, User’s Guide, 2015