Ready to leave traditional insulin delivery methods behind?
Once you and your healthcare provider have determined that pump therapy is right for you, complete and submit the online Patient Information Form below or download the form, complete it and fax to the Omnipod® System Customer Care Program.
A representative from the Omnipod® Customer Care team will begin the process of working with your insurance provider to determine your coverage.
We’ll follow up with you to confirm your prescription and arrange for the shipment of your Omnipod® System Insulin Management System.
AM I COVERED?
The Omnipod® Insulin Management System is covered under various provincial and private healthcare plans across Canada.
Once you have completed and sent back the Patient Information Form our Omnipod® Customer Care Program will be best equipped to answer your coverage questions. They can be reached at 1-855-POD-INFO (1-855-763-4636).
Patient Information Form
Online Patient Information Form
Click here to complete and submit the Patient Information Form online
You will receive a confirmation email following submission. A representative from the Omnipod® Customer Care team will begin the process of working with your insurance provider(s) to determine your coverage.
Should additional information be required, a member of the Omnipod® Customer Care team will contact you directly.
Download Patient Information Form PDF
Prefer to send your forms via mail or fax?
Click here to download and print the Patient Information Form
Fax the completed form to our confidential fax line at:
Mail it to:
Customer Care Insulet Canada Corporation
1540 Cornwall Drive Suite 201 Oakville, Ontario L6J 7W5
Need assistance filling out your form?
Our team of Omnipod® Specialists are available to help you every step of the way. Simply call:
The Pod has a waterproof IP28 rating for up to 7.6 meters (25 feet) for up to 60 minutes. The PDM is not waterproof.