To receive a $3.00 off coupon* on any 400mL bottle of pHisoderm Daily Facial Cleanser simply fill out the information below.

* Indicates required fields

*In a typical week, how often do you use the following?

Facial Cleanser: None Once 2-3 times 4-5 times 6+

Facial Moisturizer: None Once 2-3 times 4-5 times 6+

*How did you hear about pHisoderm.ca?

I use pHisoderm
Friend/Family told me
Magazine Advertisement
I received a coupon from the LifeFest 2007 Event
Packaging
Link from Other Site
In-store feature/promotion
Other  

* Please pick from the following menu the retail locations you typically purchase your skin care products

Shoppers Drug Mart
Wal-Mart
The Bay
Loblaws
Grocery Store
Other  

* First Name

* Last Name

* Email Address

* Home Address
(CDN residents only)

* City/Town

* Province

* Postal Code

* Age

Phone Number

We take great precautions to keep the information you share with us safe and private. We will not sell or give your personal information to other marketers without your express consent. However, from time to time, we would like your permission to send you free product samples, sneak previews of new products, or personalized offers or tips. We also may ask for comments on how to improve our product or programs. In order to do so, your information may be securely shared with our agencies. Visit www.mentholatum.ca for full details of our privacy policy.

*Please notify me about exciting information, samples and contest info from pHisoderm.

*Coupon expires December 31, 2009. All coupons will be mailed to the address entered. Available for residents of Canada 18 years and older only. Limit one coupon per household while quantities last.