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Follow these steps to get your FREE TRIAL of CIALIS

PRINT
Print this CIALIS FREE TRIAL voucher.

DOCTOR
See your doctor and find out if CIALIS is right for you.

PHARMACY
If prescribed CIALIS, take your prescription and the voucher to your pharmacist.

Beware of counterfeit CIALIS


To help make sure you're getting real CIALIS, take your prescription to an accredited US-based pharmacy.

Here's your FREE TRIAL voucher


This voucher is being provided to you by Lilly USA, LLC, for 1 FREE TRIAL of CIALIS (tadalafil) tablets. This voucher is valid in the US and Puerto Rico for residents of the US and Puerto Rico. This offer may be terminated by Lilly USA, LLC, at any time. Valid for: 30 tablets of 2.5 mg or 5 mg CIALIS or 3 tablets of 10 mg or 20 mg CIALIS, as prescribed by your healthcare provider. Limit: 1 FREE TRIAL of CIALIS per patient per 12-month period across all CIALIS programs.

RxBIN#
015251

PCN#
PRX2000

Group#
CIALISWEB

Identification#
CPWB8653215

Expires
03/28/2013

To the Pharmacist: Submit the claim to OPTUMRx. Valid Prescriber ID#, Patient Name, and DOB are required for claim adjudication Offer good only with a valid prescription for CIALIS This voucher is valid in the US and Puerto Rico for residents of the US and Puerto Rico Valid for 30 tablets of 2.5 mg or 5 mg CIALIS or 3 tablets of 10 mg or 20 mg CIALIS as prescribed by a healthcare provider Please dispense this Eli Lilly and Company product at no cost or co-pay to the patient Note the expiration dates on the program vouchers. Vouchers presented after the expiration date should not be honored Please remove this identification number from the patient profile after the claim is processed For assistance in filing this claim, please call the OPTUMRx Help Desk at 1-800-510-4836 Offer terms: Offer void where prohibited by law. Product dispensed pursuant to the terms of this voucher shall not be submitted to any third-party payer, public or private (e.g., Medicaid, Medicare, private insurance, any governmental program, or any other federal or state program such as CHAMPUS, the VA, TRICARE, or a state pharmaceutical assistance program) for reimbursement. Offer valid in the US (and Puerto Rico, if applicable) only. This offer is not valid with any other program, discount, or incentive involving CIALIS. It is illegal for any person to sell, purchase, or trade; or to offer to sell, purchase, or trade; or to counterfeit this voucher. No purchase required. Use of this voucher does not create any obligation or involve any past or future purchase requirement. Lilly USA, LLC reserves the right to rescind, revoke or amend this program/offer without notice at any time. You understand and agree to comply with these offer terms. This information is intended for use by US residents aged 18 or older. If you have a medical emergency, call 911 or the closest medical facility. If you have a question about a Lilly product, please call 1-800-LillyRx (1-800-545-5979). CIALIS is a registered trademark of Eli Lilly and Company. TD80214 11/2012 2012, LILLY USA, LLC. ALL RIGHTS RESERVED.