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Diovan HCT Logo

Indications and Important Safety Information

Save online. Save more over the phone. Register by phone and pay only $4 for a 30-tablet prescription. Call 1-888-308-0295. Register online below and pay only $25 for a 30-, 60-, or 90- tablet prescription.

Thank you for your interest in Diovan and Diovan HCT. Please complete the form below to register for valuable savings, get information about Diovan, and gain access to tools and resources to help you manage your condition.

By completing this registration, you will be enrolled in our high blood pressure support program, Get on Track^™. The Get on Track Program^™ offers interactive online tools and helpful information delivered to the email
and/or cell phone that you provide.

If you have already received your offer and it is lost or damaged, or if you are still waiting for it to arrive,
please call 1-888-534-7480.

Notice

The personal information you supply to us will be shared with and among our business partners to provide you with products, programs, and services regarding High Blood Pressure and cardiovascular conditions and to conduct market research. Your information may be combined with additional information from this or other programs in which you participate, such as prescription information when you redeem savings cards or vouchers. We do not permit our business partners to use or share your personal information for their own separate marketing purposes. You have the right to unsubscribe at any time by calling 1-888-669-6682.

For further information about Novartis privacy practices, please review our privacy policy at: www.pharma.us.novartis.com

* Required field

* First Name:

* Last Name:

* Address:

* City/Town:

* State:

* ZIP Code:

Home Phone Number:

Cell Phone Number:

* Your E-mail:

* Retype E-mail:

* Date of Birth:

* Please tell us your gender:

Male

Female

I agree to receive marketing calls from Novartis Pharmaceuticals Corporation at the phone numbers listed above. I understand that my cell phone carrier's standard rates may apply for calls or text messages to my cell phone. I understand that any information in my text messages cannot be secured against unauthorized access.

* May we leave a message on your answering machine if unable to reach you?

Yes

* Did you receive a Diovan card or voucher (with a 12-digit membership ID) from your healthcare professional?

Yes

If yes, please provide your 12-digit membership ID for our records:

Consent

I agree to receive marketing information, offers and promotions regarding High Blood Pressure and cardiovascular conditions and also agree that I may be contacted for my opinions regarding products, programs and services. I understand that the information that I provide will be used in accordance with the above Notice and the Novartis Privacy Statement. My consent will remain valid until I unsubscribe.

I would also like to receive information regarding all Novartis Pharmaceuticals Corporation products, programs, and services.

Diovan Patient Savings Terms & Conditions

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