Edit, Download, and Sign the Alcon Contact Lens Rebate Submission Guidelines
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How do I fill this out?
Filling out the rebate form is simple and straightforward. Begin by gathering all necessary documents, including your unique rebate code. Make sure to follow the outlined steps carefully for successful submission.

How to fill out the Alcon Contact Lens Rebate Submission Guidelines?
1
Gather all required documentation.
2
Locate your unique rebate code.
3
Fill out the rebate form completely.
4
Submit your form online or by mail.
5
Keep a copy of your submission for your records.
Who needs the Alcon Contact Lens Rebate Submission Guidelines?
1
Consumers purchasing Alcon contact lenses for personal use.
2
Optometrists distributing lenses who need to inform patients about rebates.
3
Employees of eye care providers to assist patients with rebate submissions.
4
Health insurance providers who verify purchases for claims.
5
Retailers involved in selling Alcon contact lenses.
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What are the instructions for submitting this form?
To submit your rebate claim, visit AlconChoice.com and enter your unique rebate code. You can also download and print your rebate form, filling it out clearly with all required details. Once completed, submit it via mail or online using the guidelines provided on the website.
What are the important dates for this form in 2024 and 2025?
The promotional period for this rebate is from August 1, 2019 to January 31, 2020. Ensure to submit your form within 60 days of your purchase and after your eye exam to qualify for the rebate. For 2024 and 2025, check for further promotional announcements related to Alcon rebates.

What is the purpose of this form?
The purpose of this form is to enable consumers to submit a rebate claim for their Alcon contact lens purchases. This document ensures that all necessary information is collected for processing the rebate effectively. By using this form, you can track your submission and receive your rebate timely.

Tell me about this form and its components and fields line-by-line.

- 1. Unique Rebate Code: A specific code assigned to your rebate claim.
- 2. Purchase Details: Information about the lenses purchased.
- 3. Eye Exam Receipt: Details of your recent eye exam or lens fitting.
- 4. Sales Receipt: Proof of purchase for the contact lenses.
- 5. UPC Code: A barcode representing the product for rebate verification.
What happens if I fail to submit this form?
If you fail to submit the form correctly, your rebate claim may be denied. Make sure all documents are filled out accurately to avoid issues.
- Missing Documentation: Claims cannot be processed without all necessary documents being provided.
- Incorrect Rebate Code: An invalid or missing rebate code will lead to claim rejection.
- Late Submission: Submitting past the deadline will result in your claim being disqualified.
How do I know when to use this form?

- 1. After Purchase: Fill out the form right after purchasing your contact lenses.
- 2. Post Eye Exam: Use this form following your eye exam or lens fitting.
- 3. For Insurance Claims: This form can assist in verifying purchases for insurance reimbursement.
Frequently Asked Questions
How do I submit my rebate claim?
You can submit your rebate claim online or by mail as per the instructions provided in the rebate form.
What documents do I need to submit?
You will need your unique rebate code, a sales receipt, an eye exam receipt, and a UPC from one box of lenses.
Is there a deadline for submission?
Yes, you must submit your rebate claim within 60 days of purchase.
Can I edit this PDF?
Yes, you can easily edit this rebate PDF using our tools on PrintFriendly.
What if I lose my unique rebate code?
Unfortunately, the rebate code cannot be reissued, so it's important to keep it safe.
How will I receive my rebate?
Rebates are paid via a Visa prepaid card sent to your email.
Can I submit a claim by phone?
No, claims must be submitted online or via the mail.
What should I do if I don't receive my confirmation email?
If you don't receive your confirmation email, check your spam folder.
Can I submit claims for multiple rebates?
Yes, but you can submit a limit of one rebate per person, per year.
Is this rebate offer valid for all retailers?
No, the rebate is only valid for purchases made through participating eye care providers.
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