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Join the Prevacid^®24HR Action Program

Feel like frequent heartburn has a way of crashing all the important occasions and everyday pleasures in your life? Our free support program will teach you all sorts of ways to keep heartburn from ruining the party. Simply fill out the short form below so we can make your program as personal and action-packed for you as possible.

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First Name*

Last Name*

Email*

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Password*

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Screen Name*

Gender*

Male

Female

I am eighteen years of age or older.*

Tell Us About Yourself...

1. What time of day do you experience your frequent heartburn (occurs 2 or more days per week)? (please check as many as apply)

	Morning
	Afternoon
	Evening
	Night

2. Which of the following, if any, have you used in the last 3 months to treat your frequent heartburn? (please check as many as apply)

	Prevacid^®24HR (OTC)
	Prevacid^® (Rx)
	Prescription medicine other than original Prevacid^® (Rx) (e.g. Nexium^®, Aciphex^®, Protonix^® or Zegrid^®)
	Prilosec OTC^®
	Store brand version of Prilosec OTC^®
	Over-the-counter medicine like Pepcid^® or Zantac^®
	Store brand versions of over-the-counter medicine like Pepcid^® or Zantac^®
	Antacids like Tums^®, Maalox^® or Rolaids^®
	Store brand versions of antacids like Tums^®, Maalox^® or Rolaids^®

3. Which of the following would you be interested in receiving as part of the Prevacid^®24HR ACTION Program? Please check all that apply.

	Recipes and information on diet and nutrition
	Party planning tips for sports and entertainment events
	Contests and sweepstakes
	Coupons and money-saving offers
	Helpful tips about lifestyle and hobbies like gardening, scrapbooking or pets
	News about medical developments for heartburn
	Tips for enjoying heartburn-free holidays
	Games and puzzles
	Information about nighttime heartburn relief
	Short jokes or funny stories
	Access to online book clubs

*Please indicate your preferences for receiving additional information:

	Yes, I would like to receive information about products, programs and services offered by Novartis Consumer Health, Inc.
	No, I would not like to receive additional information about products, programs and services offered by Novartis Consumer Health, Inc.

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Prevacid^®24HR may take 1-4 days for full effect, although some people get complete relief of symptoms within 24 hours.

Prevacid^®24HR is indicated for the treatment of frequent heartburn, which occurs 2 or more days a week. Use as directed for 14 days. You may repeat one 14-day course every 4 months or as directed by your doctor. If your heartburn continues or worsens stop use and ask your doctor.

This site is intended for U.S. residents only. Non-U.S. residents click here.

Prevacid^® is a registered trademark of Takeda Pharmaceuticals North America, Inc., and is used under license.
© 2009 Novartis Consumer Health, Inc.