Roche Accu-Chek Instant Manual
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Roche Accu-Chek Instant Manual

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PRESCRIPTION
CHANGE REQUEST
Dear Healthcare Professional,
I have changed my blood glucose testing system and I require a
prescription change to:
Accu-Chek Instant system
Instant Test Strips (50)
Name
Postcode
FastClix Lancets (204)
Date of Birth (DOB)

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Summary of Contents for Roche Accu-Chek Instant

  • Page 1 PRESCRIPTION CHANGE REQUEST Dear Healthcare Professional, I have changed my blood glucose testing system and I require a prescription change to: Accu-Chek Instant system Instant Test Strips (50) FastClix Lancets (204) Name Postcode Date of Birth (DOB)
  • Page 2 ACCU-CHEK, ACCU-CHEK INSTANT and FASTCLIX are trademarks of Roche. All other product names and trademarks are the property of their respective owners. Roche Diabetes Care Limited, Charles Avenue, Burgess Hill, West Sussex, RH15 9RY, UK. Company Registration Number 9055599 For use in the UK & Ireland only. This document is intended for the use of People with Diabetes with their Healthcare Professionals.

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