MUST BE COMPLETED FULLY TO ENSURE MERIAL VISA® PREPAID CARD REDEMPTION. PLEASE PRINT INFORMATION.

— TO BE COMPLETED BY PET OWNER —
Available only on purchases from your veterinarian. Coupon expires 1/31/2018.
Original receipt must accompany form.

Westside Veterinary Clinic
4736 Country Club Dr
Jefferson City, MO 65109
POID: XXXXXXXX
Email Adress:__________________________
Pet's Name: __________________________
Pet's Birthday (MM/DD/YY): _____/_____/_____
Merial respects your privacy. We will not share, sell or rent the information you provide on this form. By providing your email address, you agree to receive emails with special coupons, offers and information from Merial. Product must be dispensed on or before 1/31/2018.
  • Complete the following for your $50 Visa prepaid card:
  • HEARTGARD® Plus
    (ivermectin/pyrantel)
  • 12 Doses
  • FRONTLINE Brand Products
    16-93500 16-93500-XXXXXXXX
    NexGard® (afoxolaner)
    16-93498 16-93498-XXXXXXXX
  • Complete the following for your $25 Visa prepaid card:
  • HEARTGARD® Plus
    (ivermectin/pyrantel)
  • 6 Doses
  • NexGard® (afoxolaner)
    16-93495 16-93495-XXXXXXXX

Rebate request must be received on or before 4/1/2018 and must be accompanied by original receipt. One coupon required for every 12-pack of HEARTGARD Plus and either every 12 doses of FRONTLINE brand product purchased or every 12 or 6 doses of NexGard purchased.

Redeem at HEARTGARD Plus Program Headquarters
P.O. Box 540069 • El Paso, TX 88554-0069

FOR VETERINARY CLINIC USE ONLY:

32246-68316
Westside Veterinary Clinic
4736 Country Club Dr
Jefferson City, MO 65109
MERIAL® Rewards #:______________
MERIAL Rewards Name: _______________________
This card is issued by MetaBank®, Member FDIC, pursuant to a license from Visa U.S.A. Inc.
THIS OFFER MAY NOT BE COMBINED WITH ANY OTHER OFFER.
ORIGINAL ITEMIZED RECEIPT MUST ACCOMPANY FORM and indicate a HEARTGARD and FRONTLINE brand product or NEXGARD purchase and be included and dated on or before 1/31/2018. Rebate request must be received on or before 4/1/2018. This offer may not be combined with any other offer. Merial reserves the right to amend, substitute, or withdraw this offer at any time without notice. Offer may be redeemed only by pet owner. Good only in continental U.S. and Hawaii. Void where prohibited or restricted by law. All federal, state and local laws and regulations apply. This form must accompany request; reproductions or other copies will not be accepted. Fraudulent submission could result in federal prosecution under mail fraud statutes (Title 18, United States Code, Section 1341 and 1342) and applicable state laws.
Merial Merial is now part of Boehringer Ingelheim.
®MERIAL, FRONTLINE, NexGard, HEARTGARD and the Dog & Hand logo are registered trademarks, and ™FRONTLINE VET LABS is a trademark, of Merial. All other marks are the property of their respective owners.
©2017 Merial, Inc., Duluth, GA. All rights reserved. CC17COMBO (01/17).