JA | Lilly Diabetes Journey Awards | A celebration of lives well lived.
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Lilly Diabetes Journey Awards℠ Type 1 Patient Application

Please Note: Journey Awards is a United States-only based program and is intended for eligible applicants with Type 1 diabetes. All required fields are marked with an *.

Award Type Selection

Type 1 Patient Information

By providing my telephone number and clicking “SUBMIT”, I agree to receive automated marketing calls and texts from and on behalf of Eli Lilly and Company. I understand that I am not required to provide my number as a condition of purchase. Message and data rates may apply.
Please Note: P.O. Box addresses cannot be processed.

Please Note: Limit for engraving is 20 characters with spaces.

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.
For more information about Lilly’s privacy practice, please view the Privacy Statement.

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.