Begin Your Application

Step 1: Gather your Materials

Before you download your application you will need to prepare some materials.

• Pharmacy License
• DEA License
• PIC License
• Liability Insurance

You will end up faxing these documents to UPNI along with your application form.

Step 2: Download Your Application

Each membership application is different, so please review the features of each membership level HERE to decide which one best suits your needs. Once you’ve decided, please click one of the links below to begin you application download.

Step 3: Fax Your Materials To UPNI

Once you’ve opened the application document, you will be able to type in all the information required. When you are done, print it out, sign it, and Fax the application along with the additional materials mentioned in the first step to: (818) 549-2280

If you have any comments or questions please do no hesitate to CONTACT US.