Instructions:
Click the blue hyperlinks to download each form.
1.) Pay for the Licensee Origination Fee
** No fee necessary if you have a virtual office or tele-health clinic.
Click here to make your payment
2.) Apply for United Credit Patient Finance
** No application necessary if you already have Care Credit.
3.) Return the completely filled out Licensee Intake Form and Agreement to BMarulli@DiabetesReversalGroup.Com
-> Licensee Agreement
-> Licensee Intake Form
Have questions?
Contact our Chief Revenue Officer, Bob Marulli, at 817-934-5675.