DOWNLOAD OR ACTIVATE
A RELISTOR SAVINGS CARD
We need to know a little more about you before you can activate or download your card.
Please fill out the information below. Asterisk (*) indicates required question.
Please note, in order to download your card, you must have Adobe® Reader installed on your computer or mobile device. If you do not have this program, click here to download.
By clicking “Submit” and activating a Relistor Savings Card, I confirm that I have read and understand the Eligibility Criteria, Terms and Conditions contained above, and that the patient who will use the savings card meets all eligibility criteria and will comply with all terms and conditions of the program.