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Allergan OPTOMETRY JUMPSTART® is a program specifically designed for newly graduated optometrists practicing in the United States. Members gain access to many exciting resources through a dedicated Allergan sales representative. We invite current optometry students and recent graduates (up to 5 years post graduation) to register for the program.

Program benefits:

Optometry students:

  • Annual Optometry’s Meeting® travel grant opportunities*
  • REFRESH® Brand Tears samples
  • Access to optometric publications
  • Invitations to special events at major conferences

Practicing optometrists:

  • Monthly support calls from a dedicated Allergan sales representative
  • Immediate access to samples of REFRESH® Brand Tears
  • Allergan Eye Care prescription product samples for patients who need them
  • Educational videos
  • Up-to-date information about Allergan Eye Care products
  • Savings programs to help eligible patients with out-of-pocket costs
  • Patient education and counseling materials
  • Invitations to speaker programs delivered by industry leaders

*The goal of the Travel Grant Program is to actively help optometry students attend Optometry's Meeting® to promote the optometric profession and help students overcome financial barriers to attending. The grant is open to all students at the schools and colleges of optometry. Students do not need to be an OPTOMETRY JUMPSTART® member to be eligible for a travel grant. Travel grant winners are determined through a contest in which the American Optometric Student Association (AOSA) judges the submissions and determines the travel grant winners.


Note: Registration is available anytime during optometry school and up to 5 years post graduation.

*Required field.

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Section A: TO BE COMPLETED BY ALL APPLICANTS
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†Required for students only.

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Required

Your mobile phone number will be used to contact you after graduation to update your contact information.

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Would you like to receive text messages from the Allergan OPTOMETRY JUMPSTART® program? Examples of texts include messages regarding the status of product sample shipments, appointment scheduling, and other resources. Consent to receive texts is not required as part of the OPTOMETRY JUMPSTART® program.

Yes, I would like to receive text messages from the Allergan OPTOMETRY JUMPSTART® program.

The frequency of these messages depends on user preferences/activity, and message and data rates may apply. You can unsubscribe at any time by texting “STOP” to <insert number>.

Section B: TO BE COMPLETED BY FOURTH-YEAR STUDENTS AND GRADUATES ONLY

Please complete all of the known fields below.

Are you, or will you be, employed by either of the following in the next 12 months?

Indian Health Service
Veterans Health Administration

If yes, what best describes your employment status with them?

Required
My employment is temporary due to my residency placement and is scheduled to end:  

My employment is permanent.

Are you, or will you be, employed by either of the following in the next 12 months?

Henry Ford Health System
Kaiser Permanente
Section C: TO BE COMPLETED BY ALL APPLICANTS

Yes, I would like to join the Allergan OPTOMETRY JUMPSTART® program and agree to receive future communications from Allergan.* Required







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© 2019 Allergan.  All rights reserved.  All trademarks are the property of their respective owners.  www.allergan.com  AOT114246-v2  09/19  190876

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