New to B12 LOVE? Register Here
If you have visited a B12 LOVE location before, then you’re already in our system.
Please email firstname.lastname@example.org and we’ll send you an email to access your account.
Also, please note, this is a medical form and we will need your name, date of birth, current phone number, valid
mailing address, and signature prior to receiving a service at B12 LOVE.