Please download and print the Application forms OR use the secure online form.
We will need this application prior to your product intake.
Product intake is by appointment ONLY. We will have our phone soon!
We also require an Confidential Tax Return Form. ( click here) This form can be completed at the time of product intake and is kept in a separate secure location.
Please note we will still require a copy of your drivers license and 215 doctor recommendations. So don't forget to mail copies to First MC Processing, PO #315, Redway, CA 95560.