MINIMED™ 770G SYSTEM

NEW CONTINUOUS GLUCOSE MONITORING

TRAINING CHECKLIST

Certified Product Trainer:

Training Date: Start Time: End Time:

Patient Name: KIT#:

Pump S/N#: Infusion Set:

Have patient check Blood Glucose (BG) prior to training session Yes BG: Declined
All training categories (as appropriate) must be checked & patient/trainer signatures included prior to submitting to Medtronic.
PLEASE PRINT.

Check all that apply: Getting Started With MiniMed 770G Continuous Glucose Monitoring Yes No
Completed Online Training Video(s) Yes No

KEYS TO SUCCESS:

1) Sensor Glucose (SG) ≠ Blood Glucose (BG)

Patient has verbalized understanding of:

Difference between SG and BG BG confirmations required for diabetes management decisions

2) Trends
Patient has verbalized understanding of:

Importance of focusing on trends vs. SG value Single, double, and triple trend arrows

3) Personalized Alerts
Importance of personalizing alerts
All settings entered as per the MiniMed™ 770G System initiation settings
form
High Settings
Time Glucose Limit Alert before high Alert on high

Snooze min

Low Settings
Time Glucose Limit Alert before low Alert on low Suspend before low Suspend on low

Snooze min

4) Sensor Insertion
Patient has verbalized understanding and demonstrated the following:
Connecting pump and transmitter Ensuring thumb is on thumbprint when loading serter
Site selection, rotation, and preparation Importance of holding serter against body after insertion
Proper steps to GuardianTM sensor (3) insertion using One-press serter Applying pressure to sensor adhesive

5) Sensor Taping
Patient has verbalized understanding and demonstrated the following:
Importance of applying overtape Connecting transmitter to sensor
Steps for applying overtape correctly Applying adhesive tab carefully onto transmitter
Applying pressure to overtape

Comments:

I certify that I received and understood the full and complete training mentioned above:

Patient Signature:
Patient Name:

Starting the Sensor

Patient has verbalized understanding of:
Starting new sensor Reading Home screen, sensor graphs and icons
Warm-up Reading Sensor status screen

6) Calibration
Patient has verbalized understanding of:
Calibration options
Importance of calibration
Optimal times to calibrate
Calibration schedule and tips

Key to Success: CareLink™ Personal Software

Discussed the value of using CareLink Software CareLink Software registration:
Patient referred to website (carelink.minimed.eu)* Username:

Sensor Alerts, Suspend before low and Suspend on low

Patient has verbalized understanding of:

Clearing alerts and alarms Understanding Suspend before low feature Steps to manually resume delivery
Common sensor alerts reviewed Understanding Suspend on low feature Auto resume
Home screen during Suspend

Additional topics reviewed include:

Charging/Cleaning the transmitter Calibration Reminder
Removal for X-ray, CT Scan, MRI MiniMed™ Mobile App
Alert Silence Rise Rate of Change alert disabled

The following have been completed if applicable:

Follow-up plan outlined Auto Mode training scheduled Yes No
Auto Mode Training date scheduled for:

Additional Comments:

6 – 7 day follow-up phone call: Date    /   /   Time Spent   min

Review scheduled for:

A minimum of 6 days of CGM data is recommended

By signing below the patient acknowledges that they have received and understood the full and complete training mentioned above and consents to a
copy of this document being forwarded to Medtronic, along with future pertinent Medtronic forms/documents, for administrative, quality and patient
safety purposes only.

Patient Signature: Date:

Trainer signature: Date:

FAX COMPLETED FORM WITHIN 30 DAYS OF TRAINING TO 1-800-326-8322 or send scan/photo (in pdf format) to your specific Region’s email address:
rs.cancptinvoiceon@medtronic.com for ON, rs.can-cptinvoice-west@medtronic.com for BC/AB/MB/SK,
rs.can-cptinvoice-east@medtronic.com for NS/NB/NL/PEI, rs.can-cptinvoice-qc@medtronic.com for QC
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