Insulin Pump Battery Cap

Battery Cap Replacement Request

Please complete the form below to request a replacement battery cap.

For more information, please read the Insulin Pump Battery Cap notification letter. You can also view the animated/video instructions on how to inspect the battery cap contact by clicking here.

As a reminder:

	The battery cap can be found on the top of the pump where the AA battery compartment is located
	Undamaged battery cap – Continue to use Has three raised, round, black, plastic dots holding metal contact in place
	Damaged battery caps – Do not use Metal contact is missing, or fewer than 3 raised dots can be seen

Do you have a backup battery cap to use? *

Account number (7 digits) Enter the number only

Where to find your account number?
Refer to your Medtronic invoice to locate your account number

Pump user first name*

Pump user last name*

Email address on Pump User Account *

Phone number*

Pump user date of birth*

Serial number (7 digits)* Enter the number only

Example: NG 1 2 3 4 5 6 7 H

Where to find your serial number?

Address* (Physical address required, no PO boxes)

City*

Province*

Code postal*

Exemple: K1A 0B1

Country/Region

I understand that the replacement battery cap request will be processed as inventory becomes available and that I will be notified via email when the battery cap has been shipped*

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