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NEILMED REBATE CENTRAL - ONLINE REBATE SUBMISSION APPLICATION
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To check the status of your rebate, please click here to view our 24hr customer service numbers.
Personal Details
Name
  First name       Middle initial    
  Last name  
Address
Address 1 Address 2
Address 3
City/Town Zip/Postal Code
Country State/Province/County
Phone Email
Physician Details
Physician Name Physician Specialty
Address
City/Town Zip/Postal Code
Country State/Province/County
Phone    
Product Details
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Please do not press SUBMIT button more than once as it will create duplicate entries
 
If you have any problems using the system please email to questions@neilmed.com or
call toll free (USA & Canada) 1 877 477 8633

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