REBATE ON PATADAY^™ solution

Get your $10 PATADAY^™ solution rebate in these simple steps:

Visit your healthcare provider and ask about a prescription for PATADAY^™ solution.
Pick up your prescription from your pharmacist. Pay your applicable out of pocket costs and keep your receipt.
Fill out the required fields below and click "Next" below to generate your rebate form.
Print the rebate form.
Follow all terms and conditions and mail the rebate form to the address on the form.

You'll receive your rebate within 8-10 weeks. Visit our rebate status page for information on checking your rebate status.

Since PATADAY^™ solution is a prescription eye drop, please visit your healthcare provider and ask about getting a free sample of PATADAY^™ ophthalmic solution.

Terms and Conditions apply.

The personal information requested below will be used for aggregate research and promotional purposes only. To protect the privacy of our users, your information will not be sold to a third party.

Please complete the following required information:

*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip Code:
Phone:	() -
*Email:

*Have you ever purchased PATADAY^™ solution in the past?
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By providing the information above you will receive a rebate worth up to $10 on your next bottle of PATADAY^™ solution.

It's okay to send future Alcon allergy e-mail communications.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

IMPORTANT SAFETY INFORMATION: PATADAY^™ solution is indicated for the treatment of ocular itching associated with allergic conjunctivitis. PATADAY^™ solution is contraindicated in patients with a hypersensitivity to any components of this product. Patients who wear soft contact lenses and whose eyes are not red should be instructed to wait at least ten minutes after instilling PATADAY^™ solution before they insert their contact lenses. Safety and effectiveness in pediatric patients below the age of 3 has not been established. The most common adverse reactions to PATADAY^™ solution were cold syndrome and pharyngitis reported at an incidence of approximately 10%. Other adverse events included eye pain, blurred vision, sinusitis and headache occurring in 5% or less of the patients. The recommended dose is one drop in each affected eye once-a-day.
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REBATE ON PATADAY™ solution

REBATE ON PATADAY^™ solution