Get the FREE trial
Please answer the following questions in order to print out a copy of the coupon. You can redeem the coupon for a FREE trial once in 12 months.
Male
Female*
*CIALIS is only approved for the treatment of ED (erectile dysfunction) in men. While CIALIS is not approved for use in females, this voucher can be downloaded for partner use.
Age:
How did you first learn about the CIALIS Promise Program?
Which of the following best describes you or your partner?
Taking 36-hour CIALIS now
Taking CIALIS for daily use now
Taking Viagra® or Levitra® now
Not taking ED medicine now
Never used ED medicine
Prefer not to answer
One coupon per person in a 12-month period.

Eli Lilly and Company will not sell or rent your personally identifiable information from the CIALIS Promise Program to third parties for their marketing use.
I have read and accept the terms listed above.
Limit: One CIALIS free trial coupon per patient per 12-month period across all CIALIS programs. Prescriber: Provide your patient with this coupon and new prescription for CIALIS. Patient: Redeem at retail pharmacy. Pharmacist: Submit claim to Wellpoint NextRx. For Assistance, call 1-866-291-1621. Processor requires Valid Prescriber ID#, Patient Name and Person Code for Claim adjudication.