Q2 2026 Promo Redemption Request

Q2 2026 PROMOTION TERMS AND CONDITIONS

Offers cannot be combined with other offers and substitutions are not permitted. Promotional offers are good for purchases made between the dates of April 1, 2026 and June 30, 2026. To redeem free goods or rebates, you must submit the online Q2 2026 Promotion Redemption Form and attach the dealer invoice prior to August 1, 2026. Promotion is void if purchased product is returned. Allow 4-6 weeks for delivery of product and free goods. Free goods must be of equal or lesser value. All bundle promotions must be on the same invoice. ACTEON reserves the right to change promotions without notice. *All information included below is for reference and illustrative purposes only. Acteon reserves the right to modify or discontinue promotions at any time.
Customer Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Customer/Office Email*
Acteon Equipment Specialist Email (if known)
john.doe@acteongroup.com
Office Name*
Office Address (to mail free goods to)*

Street Address

Street Address Line 2

CityState

Zip Code
Invoice/Purchase Date*

MonthDayYear
Invoices dated AFTER June 30, 2026 are not eligible.
Select the Promotion you are Redeeming for free goods/rebate.*

Essential-2 Kit F87528Crest Splitting - 2 Tip Kit F87567BS - 2 Kit F87509SL - 2 Kit (Sinus Lift) F87519SL Intralift - 2 Kit F87536Extraction - 2 Kit F87546Crown Extension-2 Kit F87554

List the "other" promotion you are redeeming. Please include the name of the Acteon Manager that approved this offer.*
Approved By*

First NameLast Name