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Get Rebate Form
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Easily sign the form with your finger
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How to fill out the Rebate Form online
Filling out the Rebate Form online is a straightforward process designed to help you obtain benefits from the Janssen CarePath Savings Program. Follow these clear steps to ensure that your submission is completed accurately and efficiently.
Follow the steps to complete the Rebate Form online.
- Click ‘Get Form’ button to obtain the Rebate Form and open it in the online editor.
- Ensure you are registered for the Janssen CarePath Savings Program. If you haven’t registered yet, you can do so by calling 877- (877-468-6526) or visiting the provided program websites.
- Check your eligibility by contacting Janssen CarePath at 877- (877-468-6526) if you are uncertain about your eligibility.
- Complete the form by providing the required information, including your name, gender, date of birth, address, email, phone number, and the days’ supply of your Janssen medication.
- Include your 11-digit Savings Program ID number located on the front of the card.
- Attach a copy of your pharmacy receipt, ensuring it includes your name, medication details, date, and the amount paid.
- Sign the form and enter the date to confirm your agreement with the program’s terms.
- Save your changes to the form and either download it for printing or share it as directed.
- Mail the signed form along with the pharmacy receipt to the address indicated at the bottom of the form. If eligible, expect to receive your rebate check in about three weeks.
Start filling out your Rebate Form online today to take advantage of the savings program.
The definition of a rebate is a discount given to a customer at the time of purchase, or money sent to a customer after they've paid the full price.
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