Application for Obesity Treatment Proficiency Badge in Nutrition 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Applicant Information' section. Enter your first name, last name, designation, email address, phone number, street address, city, state, zip code, and medical or professional license number.
3. Next, move to the 'Application Requirements' section. Confirm that you meet all requirements by checking 'Yes' or 'No' for each statement regarding your active license and course completion.
4. In the 'Payment Information' section, indicate your form of payment. If paying by credit card, enter your credit card number and expiration date. Remember not to submit sensitive information via email.
5. Complete the 'Applicant Statement' by signing and dating the application to confirm accuracy.
6. Finally, review all sections for completeness before submitting your application via mail or fax as instructed.

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