Sign Up for LATISSE® LashPerks A special $20 rebate awaits you
Want the inside scoop on tips, news and special offers? LATISSE® LashPerks is the rewards program that delivers. Sign up now and you'll get a $20 rebate on your LATISSE® purchase. Plus, once you redeem your rebate, we'll send you a stylish bag as a special gift (while supplies last). Signing up truly has its perks.
Fill out the information below to stay connected
Prefix First Name* Last Name* Your E-mail* Create Password* Confirm Password*

1)Have you bought LATISSE®?*

2)Do you see an aesthetic doctor?*

Please indicate what type of doctor:

Please provide your doctor's name and name of practice.
Dr.'s First Name
Dr.'s Last Name
Name of Practice
Street Address Street Address 2 City State Your Zip Code* Home Phone Mobile Phone
Format (xxx-xxx-xxxx) To get future tips and
updates from LATISSE®

3) Approximately how much money do you spend on aesthetic or cosmetic products and/or services every 3 months?*

4)What is your age range?*

Enter your promotional code here:

Yes, I would like to receive future communications about LATISSE®, special offers and information.

*Required Fields
PRINT PAGEPRINT PAGE
SHARE THIS
close
LATISSE® solution is a prescription treatment for hypotrichosis used to grow eyelashes, making them longer, thicker and darker.
Eyelash hypotrichosis is another name for having inadequate or not enough eyelashes.
Important Safety Information
If you are using prescription products for lowering eye pressure or have a history of eye pressure problems, only use LATISSE® under close doctor supervision. May cause eyelid skin darkening which may be reversible, and there is potential for increased brown iris pigmentation which is likely to be permanent. There is a potential for hair growth to occur in areas where LATISSE® solution comes in repeated contact with skin surfaces. If you develop or experience any eye problems or have eye surgery, consult your doctor immediately about continued use of LATISSE®. The most common side effects after using LATISSE® solution are an itching sensation in the eyes and/or eye redness.
Please see full Prescribing Information link below.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
ALLERGAN © 2010 Allergan, Inc. Irvine, CA 92612. ® marks owned by Allergan, Inc.
JUVÉDERM® mark owned by Allergan Industrie SAS.

© 2010 Make-A-Wish Foundation of America. Make-A-Wish Foundation and the
Make-A-Wish logo are registered trademarks of the Make-A-Wish Foundation of America.

APC69GH09