Sign Up for Wellness Rewards Congratulations! You've taken the first step to achieving better health and wellness. Members of the Nature Made Wellness Advisor have the benefit of earning free vitamins, supplements, herbs, fitness DVDs, nutrition bars, vitamin guides and classical music CDs. Simply bank the Wellness Rewards code found on the package to begin earning points towards rewards. Please fill out the form below to set up your account. * First Name: M.I. * Last Name: * Street Address1: Street Address2: * City: * State: Please select a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming Your mailing address is used to send coupons that you request from our Wellness Rewards program. Currently this program is available only to U.S. residents. * Zip Code: * Email Address: (username) * Confirm Email Address: * Password:   (at least four characters) * Confirm Password: * Birth Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select a year 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 By selecting a preferred retailer, you may receive coupons to be redeemed at your favorite store. You may change it at any time or choose not to select a preferred retailer at all. * Gender: Male Female Preferred Retailer: Select Retailer A & P Supermarket AAFES Acme Market Albertsons Arrow Pharmacy & Nutrition Bartell Drugs Bashas Market BI LO BJs Wholesale Club Brooks Pharmacy Brookshire Food Store Brunos Food & Pharmacy City Market Commissary Costco Wholesale County Market Cub Foods CVS Dillon Food Store Dominicks Finer Foods Drug Emporium Drug Fair Drug Warehouse Drugstore.com Duane Reade Eagle Food Center Eckerd Drug Econofoods Family Fare Supermarket Familymeds Pharmacy Farm Fresh Food 4 Less Food City Food Emporium Fred Meyer Store Frys Food Store Giant Food Store Giant-Carlisle Haggen Happy Harry Discount Drugs Harris Teeter Supermarket HEB Hy Vee Food Store Ike’s Deep Discount Drug Ingles Jewel Food Store Kerr Drug King Soopers Store Kinney Drugs Kmart Kroger Longs Drug Marsh Supermarket Mays Drug Stores Med-X Meijer Supermarket NEXCOM Osco Drug Pavilions Pick N Save Price Cutter Publix Quality Food Center Raleys Supermarket Ralphs Rite Aid Roses Store Safeway Sav-A-Center Save Mart Sav-On Drug Store Schnuck Market Sentry Foods Shop N Save Shopko Shoppers Food & Pharmacy Smiths Food & Drug Snyders Drug Store Stater Bros Mkt Stop & Shop Super D Drug Super Fresh SuperTarget Center Target TOPS Markets Ukrops Super Market United Supermarket USA Drug Vons Market Wal Mart Waldbaums Walgreens Wegmans Weis Market Winn Dixie   * I currently use the following products (check all that apply): Nature Made ® SAM-e ® Nature's Resource ® All of the above None of the above Newsletter - (Twice per Month) See Example Our biweekly newsletter containing announcements about current health and wellness topics, our company's products, special promotions and savings. Retailer Sales Alerts - (Once per Month) See Example By working with our retail partners, we can alert you via email when Nature Made and Nature's Resource items are on sale at your preferred retailer. Special Offers - (Occasional) See Example From time to time, we will communicate via email new coupon offers, sweepstakes and other promotional offers that will help you save money! Information from our partners - (Occasional) By subscribing, you will receive valuable information from our health and wellness partners. Please uncheck any box if you do not wish to receive this special offer. *  Terms and Conditions   I have read and agree to the Terms and Conditions. *  Privacy Policy   I have read and agree to the Privacy Policy. What steps, if any, have you tried to lower your cholesterol (select all that apply)? Exercise Prescription medication Nutritional supplements Other/None If you use cholesterol reducing supplements, what have you purchased most often in the last 6 months? CholestOff CholestOff Complete Store brand Other brand None Which type of Nature Made Cholesterol reducing formula are you planning to purchase?   Original CholestOff? Which reduces the LDL or "bad" cholesterol that comes from your diet by blocking the absorbtion of dietary cholesterol CholestOff Complete? Which lowers both sources of cholesterol from your diet and genetics. It helps reduce the LDL cholesterol production in the liver which is genetic as well as dietary.   Where do you usually purchase your supplement products? At the Drug store At the Grocery store At a Mass Merchandiser (such as Wal-Mart) At a club store At a Health Food store Online Do you currently take a multivitamin? Yes No If you take a multivitamin, which one do you take? Nature Made Centrum One a Day Store Brand Other Brand Pharmavite® LLC. All Rights Reserved.

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