$200
MAIL-IN
REBATE
Offer good when you purchase a Dexcom G4™ PLATINUM
starter kit and 4-pack of sensors between 1/2/2013 and
3/31/2013. Limited time offer is open to eligible Medtronic®
insulin pump customers.
To receive your Dexcom rebate, you will need:
1. This completed rebate form.
2. The serial number of your Medtronic ® insulin pump and, if
applicable, your Medtronic MiniLink® transmitter serial number.
Complete this form and email, fax, or send in your submissions:
Email: [email protected]
Fax: 877-633-9266
Mail: Dexcom Customer Service Promotion Offer
6310 Sequence Dr.
San Diego, CA 92121
Please call toll-free (877-339-2664) with any questions. You can also inquire about
the status of your rebate by emailing: [email protected]
First Name
Last Name
Address
City
State
Zip Code
Telephone
Email
Medtronic insulin pump serial number
Medtronic MiniLink transmitter serial number (if applicable)
SN
SN GT
TERMS AND CONDITIONS - Valid for US residents aged 18 and older only. Offer open to eligible Medtronic insulin pump customers. Rebate valid only for end-using customers; not available to resellers. Clinics
purchasing kits for professional use are not eligible for this offer. Limit one (1) of each rebate offer per person, household, address or receipt.
Keep copies of materials submitted: submissions will not be returned. Any rebate submissions lost or misdirected by the Postal Service or other delivery service are not the responsibility of Dexcom. Your rebate
rights cannot be transferred, and this offer is void where taxed, restricted or prohibited by law. Money back guarantee is void upon redemption of rebate coupon. You may not combine this offer with any other offer.
Dexcom has the right to rescind, revoke, or amend this offer at any time without notice. Warning: Fraudulent submissions may result in Federal prosecution under the U.S. Mail Fraud Statutes (18 USC, Section
1341 and 1342). Please allow 10-12 weeks for fulfillment.
©Dexcom. All rights reserved. Rebate paid via Dexcom Visa® Prepaid Card issued by MetaBank™ pursuant to a license by Visa U.S.A. Inc. The Visa prepaid card is not redeemable for cash or usable at any ATM.
Terms and conditions apply to the card. Subject to applicable law, a monthly maintenance fee of $3 (USD) applies, but is waived for the first six months after the card is issued. Cards can be used at any merchants
that accept Visa debit cards. Dexcom reserves the right to substitute a check of equal or lesser value in lieu of Visa prepaid card at its discretion.
LBL-011840 Rev01