For US residents only

*You must be 18 years old or over. One request per household while supplies last.

Choose your favorite tattoo color.

Please note: All fields are required.



Please select an answer I have been diagnosed with lupus.
I think I may have lupus.
I am a family member or friend of someone diagnosed with lupus.
None of the above statements describes me.
Please select an answer SLE (systemic lupus erythematosus)
Discoid lupus
Medication-induced lupus
I'm not sure

Kidneys
Mouth
Muscles/Joints
Skin
None of the above

First name

Last name

Re-enter email address

Mailing address

City

State

ZIP code

Don't forget to click submit to get your free butterfly tattoos AND digital butterfly surprise!

By completing this form, you certify that you are at least 18 years old.

By providing your personal information, you are giving GSK and companies working with GSK permission to market to you across multiple channels, or contact you for market research, regarding the medical condition(s) in which you have expressed an interest, as well as other health-related information from GSK.

For additional information regarding how GSK handles your information, please see our privacy notice.

Join the #whyitattoo movement today!