Customer Tech Support (TESTING) We are here to provide you with ongoing Technical Support with your VitalAire Diabetes provided solutions. Please complete the form on this page and our Customer Tech Support Team will be able to assist you based on your immediate needs. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.I am *---PatientParent/Guardian/Caregiver/SpouseOtherSpecify Other *Reporter Name *Patient Name *Patient DOB *Patient Weight *Contact Number *Email Address *Select the product for which you require support *---Dexcom G6Dexcom G7 / Dexcom One+TandemG6 Dexcom Account Username *G6 Transmitter Serial Number (6) *G6 Transmitter Activation Date *G6 Sensor LOT Nr (7) *G6 Sensor Box *---3 PackSingle PackG6 Sensor Insertion Date *G6 Date of Event *G6 Sensor Insertion Site *---AbdomenArmUpper ButtocksThighOther- SpecifyG6 Specify Other Insertion SiteG6 Was Paracetamol Taken? *---YesNoG6 Display Device *---Apple SmartphoneAndroid SmartphoneTandem PumpReceiverSmartphone and Tandem PumpOther - SpecifyG6 Specify Other DeviceG6 Is this a Sensor, Transmitter, App, or Receiver Issue? *--SensorTransmitterAppReceiverG6 Sensor Error Type *---Sensor Error - Wait 3 hoursSensor Fail AlertInaccurate ReadingsCalibration ErrorPoor Patch AdhesionNeedle Retraction/Deployment IssueTransmitter Holder DetachedOther - SpecifyG6 How long did the issue last? *---Less that 1 hour1 - 3 hoursMore than 3 hoursBlood Glucose Reading *G6 Sensor Reading *G6 Did you calibrate the sensor before noticing inaccuracy?---YesNoI do not know what this meansG6 Did you calibrate the sensor after noticing inaccuracy?---YesNoI do not know what this meansG6 Which alert displays?---Calibrate NowCalibrate in 15 MinsRepeated Calibration PromptG6 Did you put an Overlay Patch On?---I used Dexcom Overlay PatchI used Other AdhesiveI used both Dexcom Patch and Other AdhesiveI did not apply any overlay patchesG6 Was the skin exposed to water within 12 hours after insertion?---YesNoG6 Is the applicator needle exposed? *---YesNoG6 Specify Sensor Error TypeG6 Transmitter Error Type---Signal Loss - Wait 30 Mins to ReconnectCritical Low BatteryTransmitter Failed /Not FoundOther - SpecifyG6 Signal Loss---Signal Loss Under 1 HourSignal Loss Over 1 HourNot reportable - signal loss is normal if experienced for less than 1 hour G6 Are you using the official Dexcom G6 App?---YesNoG6 Specify Transmitter Error TypeSelect your Dexcom deviceDexcom G7Dexcom One+Dexcom Account Username *Sensor Serial Number (21) * Where do I find this?Sensor Serial Number (21)A 12-digit number located on the side of the sensor packaging and/or the sensor applicator next to the (21), e.g. (21) 672145262287 Sensor LOT Nr (10) * Where do I find this?Sensor Lot Number (10)A 10-digit number located on the side of the sensor packaging next to LOT or next to the (10), e.g. (10)1553678099Sensor Kit Insertion Date *Date of Event *Sensor Kit Insertion Site *---AbdomenArmUpper ButtocksThighOther SpecifyIs this a Sensor, App, or Receiver Issue? *--SensorAppReceiverSensor Error Type *---Sensor Error - Wait 3 hoursSensor Fail AlertInaccurate ReadingsCalibration ErrorPoor Patch AdhesionNeedle Retraction/Deployment IssueSignal Loss - Wait 30 Mins to ReconnectPairing FailedNo Sensor RestartTransmitter Holder DetachedOther - SpecifyHow long did the issue last? *---Less that 1 hour1 - 3 hoursMore than 3 hoursBlood Glucose Reading *Sensor Reading *Did you calibrate the sensor before noticing inaccuracy?---YesNoI do not know what this meansDid you calibrate the sensor after noticing inaccuracy?---YesNoI do not know what this meansWhich alert displays?---Calibrate NowCalibrate in 15 MinsRepeated Calibration PromptDid you put an Overlay Patch On?---I used Dexcom Overlay PatchI used Other AdhesiveI used both Dexcom Patch and Other AdhesiveI did not apply any overlay patchesWas the skin exposed to water within 12 hours after insertion?---YesNoIs the applicator needle exposed? *---YesNoHow long?---Signal Loss Over 1 HourSignal Loss Under 1 HourAre you using the official G7 App?---YesNoIs this a new Sensor?---YesNoSpecify Sensor Error TypeApp Error Type---No Data (Follow App)Server ErrorNo Alerts & Alarms ReceivedSpecify Receiver Error TypeIf you are experiencing an issue with your Tandem Pump where insulin is not being delivered, please contact Customer Tech Support on 0861 339 266 to resolve telephonically Tandem Pump Serial NumberDate of Event *Insulin Used---HumalogNovorapidOtherSpecify other insulinIs this a cartridge, infusion set, pump accessory or pump touchscreen issue?---Infusion SetCartridgeAccessoryCracked/Shattered Tandem Pump ScreenInfusion Set Type---AutoSoft 90AutoSoft 30TrusteelInfusion Set LOT NrCartridge LOT NrAre you able to load a new cartridge and resume Insulin delivery? *---YesNoIf no, Contact Customer Tech Support on 0861 339 266 for immediate assistance Select Accessory (Lost items are not replacable/reportable)---USB rubber doorPump CaseScreen ProtectorOtherSpecify Tandem Accessory IssueIs the Touchscreen cracked or shattered?---CrackedShatteredIs the pump sill functional?---Yes, I am receiving insulin and can operate the pumpNoIf you are experiencing an issue with your Tandem Pump where insulin is not being delivered, please contact Customer Tech Support on 0861 339 266 to resolve telephonically What was your BG at the time?How did the pump screen become damaged?(Please attach photos of the damaged pump screen) Description of Issue *Upload an image to better illustrate the issue.Max upload 7mb per attachment | Formats: png, jpg, pdf, zip, rar, mp4, movAttachment 1Attachment 2Attachment 3 Confirm Delivery Address if replacement is authorized *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPrivacy Consent For the processing of personal information for legitimate business purposes and by Obligation of the Law as per the Consumer Protection Act, and Medicines and Substances Related Act: VitalAire collects, stores and uses the information to: a.) Perform services between the customer and VitalAire Diabetes. b.) Communicate requested information and support to customers; c.) Respond to queries, responses or complaints submitted to VitalAire Diabetes; d.) Invoicing, order processing and delivery with approved VitalAire Diabetes distributors/ approved 3rd party contracted couriers e.) Compile, process and provide complaint and related product and health information to Dexcom or Tandem for regulatory reporting purposes and post-market surveillance in the USA, Europe and South Africa; f.) Compile non-personal statistical information about diabetes management. g.) Reporting from wholesalers/ distributors, medical device serialisation and traceability as required by ISO13485 standards. Privacy Consent *I agree to the Privacy ConsentSubmit
