Application form

We are fond of involving you in our process, in order to achieve the most useful and meaningful device. Do you wish to be involved in upcoming developments (including clinical trials)? Then please fill in the form below.
NOTE: If you are applying for your child, fill in your child’s data, and in contact details use your name as contact person.

Data we are receiving by means of this online form is securely stored and used only to provide you with information related to Inreda Diabetic and the artificial pancreas we are developing. This data is not made available to any third party.


Inreda Diabetic artificial pancreas : people-centered

First name


Date of birth (dd-mm-yyyy)




Diabetes type


Which hospital is taking care of your Diabetes ?

Name hospital

City hospital


Contact details

I am applying for my child


Phone number (optional)