Thanks for accepting your invitation. After completing the form select your location area. At your first visit you can be approved and immediately shop at stores the same day.
You can review eligibility information and how our clinic works so you understand the service before you continue and submit the form below.Our representatives are ready to assist you. Please bare with us as we have a high call volume and our schedule can fill up quickly. Its quick and easy to use our online forms, scheduling your appointment only takes 2 minutes with no cost to submit this form.

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