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Coupon Reimbursement Request

Submit your Coupons + Receipts and our Customer Care Representative will reach out to you in 2 business days to process your request. 

 

Each form can be used to submit coupons for one product only. To submit coupons for another product, simply fill out a new form.

Coupons + Receipts
Upload supported file (Max 15MB)
Upload JPEG/PNG
Upload supported file (Max 15MB)
Upload JPEG/PNG
Upload supported file (Max 15MB)

Thanks for submitting! A team member will reach out within 2 business days.

Questions?

+1 416–368–3038

Qualification

This offer cannot be combined, copied, transferred, or sold. Altered, duplicated, or reproduced counselling cards will not be accepted. One counselling card per purchase of Zensa Lidocaine Cream 30g. Provide counselling to a patient regarding the use of Zensa Lidocaine Cream for their specific indication. Clearly write the indicated use on the designated space of this form. Upload a photo of the receipt from the purchase of the Zensa Lidocaine Cream 30g tube you provided counselling for. Upon receipt of your mail, we will promptly process your request. A fee for $5 will be processed for your pharmacy. For any questions or additional information, please call 416-368-3038

 

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