Want to schedule a one-on-one with Tidepool? You've come to the right place!
What is your name? *

First and last.
What clinic(s) do you work at? *

What is your role in the clinic? *

Check all that apply.

What is the best phone number to reach you at? *

This can be your office line or your cell. We will use this to communicate with you about your clinic's Tidepool account verification.
What day and time is best to reach you. We'll use this to suggest a few times for our one-on-one. *

You can peek at your calendar for this one.
How did you learn about Tidepool? *

If there's anything else you'd like to ask or tell us, you can use this space.

What topics would you like to discuss in your chat with Tidepool?

We'll be in touch to schedule time shortly!