DAILIES and AIR OPTIX Rebate Programs Instructions
This file provides essential details and instructions for participating in the DAILIES and AIR OPTIX rebate programs. It includes eligibility requirements, submission instructions, and key dates to ensure you maximize your savings. Ideal for consumers looking to take advantage of contact lens rebates.
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How do I fill this out?
To fill out this form, gather all necessary documentation related to your contact lens purchase. Be sure to have your eye exam details and purchase receipts handy. Follow the on-screen instructions carefully to ensure a successful submission.
How to fill out the DAILIES and AIR OPTIX Rebate Programs Instructions?
1
Gather purchase receipts for your contact lenses.
2
Provide eye exam details and prescription information.
3
Fill in personal information as required.
4
Double-check all provided information for accuracy.
5
Submit the finished form electronically or by mail.
Who needs the DAILIES and AIR OPTIX Rebate Programs Instructions?
1
New patients looking to try DAILIES TOTAL1® lenses.
2
Existing patients switching their contact lenses to DAILIES® AquaComfort Plus®.
3
Consumers wanting to save on their annual contact lens supply.
4
Eye care professionals assisting patients in accessing rebates.
5
Individuals needing detailed information on rebate submissions.
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What are the instructions for submitting this form?
Submit this form by email to rebates@alcon.com, by fax to 1-800-555-5555, or through the online submission portal provided on the rebate website. If preferred, mail your completed form to Alcon Rebate Processing, P.O. Box 12345, City, State, 12345. Make sure to provide all requested information for a successful submission.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include the valid purchase period through 4/30/2018. Ensure timely submission within the specified periods to receive your rebate.
What is the purpose of this form?
The primary purpose of this form is to facilitate users in claiming rebates for DAILIES and AIR OPTIX contact lenses. This form allows eligible customers to submit their rebate claims efficiently. By filling out the form accurately, users can enjoy reduced costs on their essential vision care products.
Tell me about this form and its components and fields line-by-line.
- 1. Personal Information: Input your name, address, and contact details.
- 2. Purchase Details: Provide details of your contact lens purchase including the retailer and date.
- 3. Eye Exam Information: Fill in your eye exam date and the prescribing eye care professional's name.
What happens if I fail to submit this form?
Failing to submit this form could result in lost rebate opportunities and additional costs for contact lenses. It is crucial to adhere to submission deadlines and requirements. Ensure all necessary information is completed to avoid complications.
- Late Submission: Submitting after the deadline may disqualify you from receiving rebates.
- Incomplete Information: Missing fields can lead to delays or rejection of your rebate claim.
- Ineligible Purchases: Only qualified products are eligible for rebates, verify eligibility before submission.
How do I know when to use this form?
- 1. Rebate Submission: Use this form to submit your claims for rebates on contact lens purchases.
- 2. Patient Transition: Existing patients switching lenses can also apply using this form.
- 3. Annual Supply Requests: Ideal for individuals purchasing an annual supply to maximize savings.
Frequently Asked Questions
How do I access the rebate form?
You can download the rebate form directly from the PrintFriendly site after completing your edits.
What information do I need to fill out the form?
You'll need your purchase receipts, eye exam details, and personal information.
Is there a deadline to submit my rebate form?
Yes, submission must be made electronically or postmarked within sixty days of purchase.
Can I save my edits on PrintFriendly?
You can download the edited PDF after making changes, ready for submission.
What if I make a mistake while filling the form?
You can always go back and edit the form before downloading it.
How can I contact support for issues with the form?
For assistance, call 1-855-344-6871.
Can I use the form if I’m an existing patient?
Yes, existing patients switching lenses can also apply for rebates.
What types of lenses are covered by this rebate?
The rebate applies to annual supplies of DAILIES TOTAL1® and DAILIES® AquaComfort Plus®.
What is the rebate amount I can receive?
You can save up to $200 depending on your selected lenses.
What happens if I submit my form late?
Late submissions risk disqualification from receiving the rebate.
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