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Eversense Volunteer Ambassador Form

Apply below to become an Eversense Volunteer Ambassador

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Please check those items below you may be interested in as an Eversense Volunteer Ambassador. Please note that each activity can vary regarding time commitment and the personal information you may be requested to share.
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a) Answer questions from interested diabetes patients and/or family members about the Eversense CGM system, including through the Eversense website and Facebook page
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b) Share personal experiences and opinions about diabetes management and Eversense to others both online and offline
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c) Attend local diabetes events
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d) Develop an educational video about Eversense CGM on your personal phone to share with others
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e) Provide feedback on your product experience for future enhancements
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f) Share your experiences with healthcare professionals who are not familiar with Eversense
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I agree to be contacted by Senseonics representatives and receive periodic updates regarding volunteering as an Eversense Ambassador.  (Senseonics will not share your identifiable personal or health information without your prior approval.)