American Diabetes Wholesale Call Us Toll-Free at 877-241-9002

Attention Medicare Recipients!!!

If you are on Medicare and have diabetes you may be eligible to receive diabetic supplies at little or no cost*

As part of our ongoing efforts to make diabetes management affordable to EVERY patient, American Diabetes Wholesale is pleased to announce our affiliation with an Authorized Medicare provider!. We are confident that our affiliated provider will provide you with quality products, great service and fast delivery. Please fill out the simple 3 steps form below and a qualified customer service specialist will contact you within 2 business days.

To get testing supplies and your free meter delivered directly to your door.

* Denotes a required field

1. Enter your shipping and contact information
• Free shipping provided anywhere in the country

* First Name	MI	* Last Name

Street Address 1	City

Street Address 2	State	Zip Code

* Email Address	Gender	Date of Birth

* Phone Number	When is the best time to call you?

Alternate Phone Number

2. Enter your Medicare information
• Free insurance verification is provide for diabetes supply coverage

How many times a day do you test your blood sugar level?	Enter Your Medicare Number

* I am the person named above, and by checking this box I authorize a supplier associated with American Diabetes Wholesale to contact me by telephone regarding provision of diabetic testing supplies.

* There may be no cost to you if you are a qualified Medicare beneficiary with Medicare supplement insurance. Otherwise, co-payments and deductibles apply.