$

NOTE: YOu must qualify for the coupon by answering the questions in a certain way. Please make sure your current use of pain medication is NOT Excedrin!

Otherwise you will be offered a coupon of lesser value. To receive a FREE coupon for any Excedrin product as their thanks to you, please fill out the information. You will not be asked to print - unless you do not qualify for the $5.99 coupon,this coupon is mailed to you.
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