Type 1 Patient Information
By submitting this application, I give consent for Lilly USA, LLC and its agents to contact me to provide additional information concerning the Lilly Diabetes Journey Awards Program. I represent and warrant that I am eighteen (18) years of age or older and I have read and understand the terms in this application.
At any time should you choose to rescind your consent for future contact regarding the Lilly Diabetes Journey Awards Program or any other Lilly Diabetes initiative, please notify the Lilly Diabetes Journey Awards Administrators at 1-888-545-5115.
Lilly Diabetes Journey Awards℠ is a service mark of Eli Lilly and Company.