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 valid doctor’s recommendation.
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 email@example.com. 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.