Activate Card

Please provide the following information to sign up for the savings program and activate your Instant Savings Card.

Please provide the following information to sign up for the savings program and activate your Instant Savings Card.

Parent/caregiver: Please insert your information below (not your child's).

All fields required unless otherwise noted.

Use of personal information

I understand that the information I've provided wil be used only by AbbVie and its contracted third parties to contact me by mail, email, and phone with helpful information regarding my child's condition. LUPRON DEPOT-PED, and other AbbVie treatments, products, and services. To be removed from our mailing list or request a copy of the information, contact 1-877-832-9755.