My Gemco Account

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Please note, you are registering to obtain an account with GEMCO Medical. All products, offerings, and services rendered through this website and your account are from GEMCO Medical. All Dexcom, Inc. products or services will be subject to additional terms.

Account Registration

Account Billing Information

Company/Organization Name*

D.B.A.

First Name of Medical Professional*

Last Name of Medical Professional*

Phone Number of Company*

Fax

Billing Address*

City*

State*

Zip*

Ship to a different address?

Accounts Payable Primary Contact

First Name*

Last Name*

Email*

Phone*

Fax

Pay with Credit Card

Yes No You have chosen BILL ME LATER payment method. Please continue to complete the registration. Account set up will take 1-3 business days and could delay the first order.

National Provider Identifier (NPI)

NPI*

Sales Tax Exempt for Resale Number

Tax Number*

Agreement to Terms; Privacy Policy

By checking the box(es), creating an account with GEMCO Medical and/or by signing below, I certify that:

I have read, understand and agree to the GEMCO Medical Terms and Conditions.*

I have accepted and agree to Dexcom's Terms of Use Agreement, which shall apply to the access and use of Dexcom's products and services, including, without limitation, the Dexcom G4 Pro and Dexcom G6 Pro Continuous Glucose Monitoring Systems ("Dexcom Professional Products"), as well as acknowledge receipt of the Dexcom Privacy Policy, which, among other things, applies to the collection and use of personal information in connection with the use of any Dexcom Professional Products.*

I also agree that the following terms and conditions shall apply to each purchase and/or access or use of any Dexcom Professional Product: *

Product shall be accessed and used in accordance with the Instructions for Use, User Guide and applicable law. I agree to review the product instructions with my patient before using a Product with such patient. Additional terms may apply if used with one or more connected devices.
Product shall only be purchased if/while I am a licensed and practicing medical professional. For clarity, I will only purchase a Product if I have an active and valid National Provider Number (or NPI).
Product is limited to commercial uses for the provision of care to my patients for the management of their diabetes.
Product shall not be used in connection with any research (i.e., generate data for analytics or publication, in support of clinical research/trial, and/or in support of services to the research markets, etc.).

Signature

By signing this agreement, I attest that I have authority and legal capacity to execute and deliver this agreement in agreeance with the terms and conditions.

Signee Printed Name*

Signee Title*

Signee Phone*

Login and Password

Email address *

Password *