CFUCDF Life Enrichment Program Application

There are 4 things to have complete before we can review your application:

  1. Be sure to fill out all fields on this form
  2. Be sure to download the Physician Verification Form (Download PDF Here)
  3. Have a member of your metabolic team sign/date the form
  4. Attach the Physician Diagnosis Form along with the invoice or registration of your chosen session, class, activity, or college course and email everything to michael@ucdfamily.org. OR you can snail mail the Physician Form and the Invoice/registration (online application is submitted electronically) to CFUCDF: 39252 Winchester Rd. #107-135 Murrieta, CA 92563. Email is the fastest way to begin processing your application. Invoices and registrations must be clear what the funds will pay for.

CFUCDF LIFE ENRICHMENT PROGRAM APPLICATION

This program has been made possible by a generous grant from Horizon Pharma

  • Physician Verification Form can be downloaded here.
  • If this is an Equipment Award, please tell us how this will be a benefit
  • Rules are on the CFUCDF Life Enrichment Program main page.
  • If applying for Equipment Award, tell us what you need.
  • If this does not apply simply mark N/A.
  • If this does not apply simply mark N/A.
  • If applying for an Equipment Award, please give us a description along with a pic and/or link (supply as much info as possible)
  • CFUCDF requires Proof of Registration/Invoice along with Physician’s Diagnosis Form before disbursement of funds. Please check the box to acknowledge.
  • This field is for validation purposes and should be left unchanged.

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Contact UCD Family

​Address:
39252 Winchester Road, #107-135
Murrieta, California 92563

Phone: 918-490-3055