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Step 1: Application Form

Please follow the simple steps below to determine your availability and submit your application! Please make sure to read and accept the Patients Program's Terms and Conditions.

Please answer the following questions:
Have you purchased 10 HYLO® treatments this calendar year?
Do you have the receipts for all 10 HYLO® purchases?
Have you kept all 10 HYLO® boxes with their barcode?
Which HYLO® barcodes are you submitting?
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