E-registration Form

By ticking this box, you expressly consent to the processing of your sensitive personal data, including health data, for the e-registration.

Please note that we may process and grant your request only upon previous of your express consent to the processing of your personal data, including health data, in
order to assess your medical needs. You may withdraw your consent at any time. according to the manner indicated in the Privacy Policy. Available here.

By ticking this box, you expressly consent to the processing of your health information for the purpose of receiving information about our products, offers, promotions, and
information to help you manage your diabetes. You may withdraw your consent at any time. according to the manner indicated in the Privacy Policy.

I am happy to receive information from Ascensia Diabetes Care Singapore Pte. Ltd. by:

Email

Mail

Phone

SMS/Whatsapp

Please select at least one checkbox to proceed.