Void where prohibited by law. Product dispensed as sample 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, and any other federal or state program such as CHAMPUS, the VA, TRICARE, or a state pharmaceutical assistance program) for reimbursement. Offer cannot be combined with any other free trial, coupon, rebate or similar offer. By accepting this voucher, the pharmacist certifies that (1) CIALIS has been dispensed to an eligible patient pursuant to a valid prescription for CIALIS; (2) no claim has been submitted for reimbursement to the patient or any third-party payer; and (3) participation in this program complies with all applicable laws and contractual or other obligations as a pharmacy provider. It is illegal for any person to sell, purchase, or trade; or to offer to sell, purchase or trade; or to counterfeit this voucher. This offer is valid for US (and Puerto Rico if applicable) residents only. Lilly USA, LLC reserves the right to rescind, revoke or amend this program/offer without notice at any time. Use of this card does not create any obligation or involve any past or future purchase requirement. No purchase required. You understand and agree to comply with these offer terms.
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