Application

We are currently servicing the Florida area only. Plans are in the works for expanding out of Florida.

By filling out this application, you will be considered for a free family photography session by Joe Leone Photography.

There are three easy steps to complete your application and as we know patients go through a lot, you may have a family member or close friend assist you in completing the application.

  1. Read the Recipient Terms And Conditions
  2. Download the Physician Letter to be completed by your physician
  3. Complete the form below

Once we have received your completed application, it will be reviewed and a priority will be assigned to it. Applications are accepted on a first-come, first-serve basis.

NOTE: THE DATE YOU SELECT BELOW IS NOT GUARANTEED AND IS SUBJECT TO YOUR APPLICATION APPROVAL WHICH INCLUDES RECEIVING YOUR PHYSICIANS LETTER.