Fields marked with (*) are mandatory as information will be required for proper e-registration registration purposes.
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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, andinformation 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:
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This form could not be submitted at this time. Please contact our customer support team at 1-800-348-8100.