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Give your eligible patients a free 30-day trial supply of SINGULAIR

The voucher is not insurance.

Eligible patients may receive a
free 30-day trial supply of SINGULAIR.

Prescriber:

To initiate a free 30-day trial supply for an appropriate
patient, you should:

• Read the Prescribing Information before prescribing SINGULAIR.
• Write a prescription for up to 30 tablets or packets of oral granules of SINGULAIR. No substitutions are permitted.
• Refills are not required, and there are no requirements to purchase any product or service to use the voucher. If you want your patient to continue taking SINGULAIR beyond the free trial period, please write a separate prescription based on your recommended therapy.
• Select the appropriate check box on the voucher.
• Give the valid signed prescription and the voucher to the patient along with the Patient Information for SINGULAIR.
• Eligible patients can take the voucher and the prescription to any participating eligible retail pharmacy to receive their free 30-day trial supply.
• For additional copies of the Prescribing Information, call 800-672-6372, visit singulair.com, or contact your Merck representative.

Terms and Conditions

• The voucher is valid for 1 free 30-day trial supply of SINGULAIR.
• Limit 1 voucher per patient for the duration of the program.
• Valid for 1-time use only. Free trial offer is valid only for up to 30 tablets or packs of oral granules of SINGULAIR. No purchase is necessary. Refills are not required.
• The voucher is not transferable. No substitutions are permitted. Cannot be combined with any other free trial, coupon, discount, prescription savings card, or other offer.
• The voucher is not insurance.
• You must be 18 years or older to redeem this voucher for yourself or a minor. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the recipient through the offer. The free trial supply of SINGULAIR cannot be used toward any out-of-pocket costs under any plan (such as true out-of-pocket expense [TrOOP]).
• The voucher can be used only by eligible US residents at any participating eligible retail pharmacy in the United States. Product must originate in the United States.
• The voucher is the property of Merck and must be turned in on request.
• Merck reserves the right to rescind, revoke, or amend the offer at any time without notice.
• It is illegal to sell, purchase, trade, or counterfeit the voucher. Void if reproduced. Void where prohibited by law, taxed, or restricted.
• Please read the Patient Information on singulair.com and discuss it with your doctor. Also on singulair.com is the physician Prescribing Information.
• Expiration Date: 06/30/2012.