Please fill out the form below to register your interest in our V-Go trial. Once we receive it one of our team will be in touch to start the process. 

About the trial: 
NZMS Diabetes is offering a 3 month trial of V-Go Free of charge. Training will be provided by our product specialist, as well as regular follow up to ensure you get the best out of your V-Go.  You will also receive 24/7 technical support.
In exchange, we will need to provide an HbA1c result prior to starting the trial and after the 3 months. One month after you start on V-Go we will ask you to fill out a quick survey to collect your feedback about your experience using V-Go. 

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* 1. Who are you interested in V-Go for?

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* 2. Personal Details

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* 3. Preferred method of contact? 

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* 4. Best time to contact? 

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* 5. How did you hear about our V-Go trial?

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* 6. Feel free to write any questions you may have about the process? 

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