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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.

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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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