To receive your $50 rebate for bilateral LipiFlow® Treatment Marketing Survey, download (by clicking on button below) and complete the survey form. Send the completed form and the original LipiFlow payment receipt from your eye care practice in an envelope to:
LipiFlow $50 Rebate Program
PO Box 5017
Stacy MN 55078-5017
You must have received your bilateral LipiFlow treatment between April 24, 2017 and June 30, 2017. LipiFlow treatments received as part of a clinical study or treatments where part was reimbursed by a private insurer do not qualify for rebate. Completed rebate form and original purchase receipt must be postmarked on or before July 15, 2017. Please allow 8 weeks for receipt of rebate check. One rebate per LipiFlow patient. Duplicates will not be accepted.
For rebate status, call 1-877-546-1851 or go to tearscience.mycheckstatus.com
Click the button to download Marketing Survey Form: