Become a member in just three simple steps.
1. Please complete all required fields in the application form below.
2. Upload images of your valid California ID and a picture of you holding the ID.
3. Read and consent to the Lifted Health & Wellness Membership Agreement and Member Terms & Conditions, and then click submit.
In order to receive deliveries from the Lifted Health & Wellness Collective, you must first become an approved patient/member. Simply submit the required documents and we’ll contact you when we’ve approved your membership. Documents can be submitted via the form below or emailed directly to us at firstname.lastname@example.org. If you have any questions or difficulties, feel free to contact us any time during normal business hours. Thanks for your interest in joining Lifted Health & Wellness.