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Does the person responsible for the out-of-pocket cost for the dose of GARDASIL have to provide all of the information requested in the “Primary Insured Certification” section of the rebate form?

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Does the person responsible for the out-of-pocket cost for the dose of GARDASIL have to provide all of the information requested in the “Primary Insured Certification” section of the rebate form?

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The person responsible for the out-of-pocket cost for the dose of GARDASIL must provide all information requested on the form and must sign and date the “Primary Insured Certification.” Forms that are not filled out completely or are modified will not be eligible for a Rebate. We need the phone number of the person responsible for the out-of-pocket cost in case we need to contact him or her to verify any of the health insurance information as we process the request for a Rebate.

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