If you're using an Accu-Chek

Advantage, Active or
Glucotrend meter, call* for
a free meter upgrade on:
FREEPHONE

0800 701000
and in the Republic of Ireland:
FREEPHONE

1 800 709600
P
M
1
9
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804RecordBook_PM1916v3 19/7/07 16:50 Page 48
In case of emergency please contact
Personal details
Name:
Address:
GPs name:
Address:
Tel:
Hospital clinic:
Address:
Tel:
Name of Diabetes Specialist Nurse:
Tel:
Local Diabetes UK /DFI Branch:
Secretarys name:
Address:
Tel:
Local pharmacy:
Address:
Tel:
Diabetes UK
10 Queen Anne Street
London W1M 0BD
Tel: 020 7323 1531
Website: www.diabetes.org.uk
email: info@diabetes.org.uk
Diabetes Federation of Ireland
76 Lower Gardiner Street
Dublin 1
Tel: 01 836 3022
Website: www.diabetesireland.ie
email: diabetesfederation@diabetesireland.ie
Name:
Address:
Tel:
804RecordBook_PM1916v3 19/7/07 16:50 Page 2
Medication details
Insulin
Type:
Dose:
Time:
Other medication
Type:
Dose:
Time:
Glucose testing times:
Target range: mmol/l
Body weight target:
Personal notes
804RecordBook_PM1916v3 19/7/07 16:50 Page 4
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804RecordBook_PM1916v3 19/7/07 16:50 Page 22
Call the Accu-Chek Careline* freephone
number for your chance to try for yourself.
0800 701000 (UK)
1 800 709600 (Ireland)
*To improve the quality of our service, calls received or made by
Roche Diagnostics may be recorded.
Both Accu-Chek systems come with:
Virtually pain-free testing
Lifetime guarantee
Accu-Chek Customer Careline 365 days a year
Choose the right Accu-Chek system for you.
ACCU-CHEK, ACCU-CHEK AVIVA, SOFTCLIX and LIVE LIFE. THE WAY YOU WANT. are trademarks of Roche.
2007 Roche Diagnostics
No lancing handling
means half the steps
to test
Tiny 0.6l blood
sample, and wide
easy to handle,
easy-fill strip
Easy and safe lancet
disposal in normal
household waste
Fast, 5-second
test time
No test strip handling
and self-coding means
half the steps
Convenient all-in-one
system with a drum
containing 17 built in
test strips and
detachable finger
pricker
Small 1.5l blood sample
Fast, 5-second test time
804RecordBook_PM1916v3 19/7/07 16:50 Page 24
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804RecordBook_PM1916v3 19/7/07 16:50 Page 42
Freephone Customer Careline 365 days a year
Plus Complimentary:
DVD meter-training guide and follow-up call
Batteries and quality control solution for life
Data management software
Record books and diabetes information leaflets
On-line support - visit www.accu-chek.co.uk
100% lifetime guarantee for your system
Accu-Chek design systems to suit
the way you live.
Whichever meter you choose comes with our
lifetime promise of support and help the
Accu-Chek Commitment.
No further system costs for life as well as free
access to the Accu-Chek Customer Careline.
Thats what we mean by More than a meter.
Its a promise that only Accu-Chek makes.

To register for your 100% lifetime guarantee

simply complete the form overleaf or call the
Accu-Chek Careline* on
FREEPHONE
0800 701000 (UK)
1 800 709600 (Ireland)
You can also register online at
www.accu-chek.co.uk
Register with Accu-Chek
Send via post to:
FREEPOST RRBK-AKXB-JJUE
Diabetes Care
Roche Diagnostics Limited
Charles Avenue
BURGESS HILL
RH15 9RY
No stamp necessary
To register please complete your personal details and
the information overleaf. Please make sure that you
tick the e-mail opt in box to receive information from
Accu-Chek.* Send your completed form to the
address below. No stamp necessary.
*To improve the quality of our service, calls received or
made by Roche Diagnostics may be recorded.
804RecordBook_PM1916v3 19/7/07 16:50 Page 44
ACCU-CHEK is a trademark of a Member of the Roche
Group. 2007 Roche Diagnostics. All rights reserved.
Roche Diagnostics Ltd. Charles Avenue,
Burgess Hill, RH15 9RY
www.accu-chek.co.uk
Registration form
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Address
Telephone
Email
Date of birth Signature
What best describes you?
Type 1 I Type 2 I
Insulin Pump User I Carer I
Healthcare Professional I Other I
What type of therapy do you follow?
Insulin I
Insulin & Tablets I
Tablets I
Tablets & Diet I
Diet I
How often do you test your blood
glucose?
Once a week I
More than once a week I
Once a day I
2-3 times a day I
4+ times a day I
Where did you obtain your meter?
Clinic I GP Practice I
Pharmacist I
Customer Careline I Other I
Name of meter
Serial number (on back of meter)
Name of previous meter
Are you on anticoagulation therapy
(warfarin)?
Yes I No I
*If you would like us to contact you
by email, please tick this box. I
I agree to Roche or its appointed
agents using any information I
provide on this form to contact me
with relevant information about
diabetes, product development and
promotions. If you do not wish us
to contact you further please tick
this box. I
Roche abides by the Data Protection Act 1998 and is registered as a data
controller under this Act. Your data will not be disclosed to any third party
except our appointed agents. PROM002
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