Hello,
Prior to enrolling to and/or reordering the Weight Loss By Design program, please read the following guidelines as they were designed to ensure a smooth transaction.

1. You will need the name of the Providing Physician whose office you will be attending. When asked to provide your doctor's code, please capitalize the first letter of last name of your doctor and enter in where required.
   If you do not have your doctor's last name please contact your counselor or call 215-947-2200 during business hours.
2. Payment for the program will appear on the second page. You will need Credit card #, Exp. Date, Name on Card, 3 or 4 digit security code on card back or front
   Or
   A check made out to WLBD, the check number and the bank route number (on bottom of check).
3. You will need the following information:
• Social Security Number
• Driver’s License Number or Picture ID numbers
• An address that we can ship to during business days
4. If you have been referred by someone, please identify the name of who referred you
5. You will need to know the names, dosages & time/day & reason for taking of all medications you are taking.
   (We can fill this in later if you do not have them handy.)
   Please have these bottles handy so you can give us accurate information.
6. Please do not leave any blank fields on the enrollment / reordering form. Select "No" or type "N/A" if the question does not apply to you.
7. During the enrollment, if you cannot proceed due to system errors or any reason, please call 1-267-474-8300 to receive immediate assistance.