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                Get Rebate
How it works
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                    Open form follow the instructions
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                    Easily sign the form with your finger
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                    Send filled & signed form or save
How to fill out the Rebate online
Filling out the Rebate form is a straightforward process that can help you receive savings on your prescription. This guide will walk you through each section of the form to ensure you complete it correctly and submit it with all required documentation.
Follow the steps to complete the Rebate form online.
- Click ‘Get Form’ button to obtain the Rebate form and open it in your preferred document editor.
- Provide your personal details in the designated fields, including your name, address, city, state, and ZIP code. Ensure that all information is accurate and clearly legible.
- Enter your email address to receive confirmations related to your rebate submission.
- Fill in the section labeled 'Actual amount paid for your prescription receipt' with the total amount you paid for , ensuring that this matches your pharmacy receipt.
- Sign the form in the designated area, certifying that you meet the eligibility requirements and accept the terms and conditions outlined in the form.
- Review the completed form to confirm that all information is correct and all required fields are filled.
- Mail the completed rebate form along with your original pharmacy receipt and proof of prescription to the provided address: DAP, P.O. Box 3740, Highland Park, MI 48203. Ensure that you include all three required documents to successfully process your rebate.
- After mailing, retain a copy of the mailed documents for your records, and anticipate a response within 10–14 days pertaining to your rebate status. You may receive a check for the rebate amount.
Complete your Rebate form online today to take advantage of your savings on .
To give a rebate, first, establish clear terms and eligibility criteria for the rebate program. Then, promote your offer transparently, providing details on how customers can claim their rebate. Ensure you have an efficient system in place to process requests, ensuring a smooth experience for your customers.
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