Important Safety Information
Prescribing Information Important Safety Information
Humalog Prescribing Information Important 75/25 Safety Information 75/25 Humalog 50/50 Prescribing Information Important Safety Information 50/50
Glucagon Important Safety Information Glucagon Information for the User Glucagon Information for the Physician
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Complete the questions below, read and accept the terms, and click the submit button.
Print the voucher and visit your doctor to see which Humalog® KwikPen™ is right for you.
If you receive a prescription, take it and your voucher to the pharmacy to get a free five pack of Humalog® KwikPen™, Humalog® Mix75/25™ KwikPen™ or Humalog® Mix50/50™ KwikPen™
Which mealtime insulin are you currently taking?
Humalog®
NovoLog® (insulin aspart [rDNA origin] injection)
Apidra® (insulin glulisine [rDNA origin] injection)
Other/Don't Know
Not currently taking mealtime insulin
What delivery form do you use to take your mealtime insulin?
Vial and syringe
Insulin pen device
Other
If you currently use a pen to take Humalog mealtime insulin, which specific pen do you currently use? (skip to the next question if you do not currently use a Humalog pen).
Humalog® Original Pre-filled Pen
Humalog® Kwikpen™
How long have you been taking mealtime insulin?
Less than 1 month
1 to 6 months
Greater than 6 months

Click the submit button to view and print a voucher.
NovoLog® (insulin aspart [rDNA origin] injection) is a registered trademark of Novo Nordisk A/S.
Apidra® (insulin glulisine [rDNA origin] injection) is a registered trademark of sanofi aventis.