There are 4 things to have complete before we can review your application:
- Be sure to fill out all fields on this form
- Be sure to download the Physician Verification Form (Download PDF Here)
- Have a member of your metabolic team sign/date the form
- Attach the Physician Diagnosis Form along with the invoice or registration of your chosen session, class, activity, or college course and email everything to firstname.lastname@example.org. OR you can snail mail the Physician Form and the Invoice/registration (online application is submitted electronically) to CFUCDF: 39252 Winchester Rd. #107-135 Murrieta, CA 92563. Email is the fastest way to begin processing your application. Invoices and registrations must be clear what the funds will pay for.
CFUCDF LIFE ENRICHMENT PROGRAM APPLICATION
This program has been made possible by a generous grant from Horizon Pharma