Insulin pump certificate

It is hereby certified that:

Name: _______________________________________

Born: ________________________________________

has Type 1. Diabetes and uses an insulin pump.

The person needs to carry the insulin pump as well as equipment for the pump in his or hers hand luggage. This could be equipment for medical treatment such as insulin injection pens and blood glu­cose meters.

The insulin pump may cause alarm in airport detectors etc.

It is vital for this person that the insulin pump is not removed from the body more than 30-60 minutes.

In case of problems regarding this patient and diabetes please contact:

Department of Medicine
Regional Hospital Viborg
Denmark

Phone +45 7844 7510

 

Date: _________ Signature: _________________________


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