How to Participate

If you are interested in participating in this FREE service, or have any questions about our program, please contact PureFun, Inc. at:

1-978-283-6161

and ask to speak with our “New Account Services” department.

OR,

Fill out the form below and click “Submit” and an Account Services Representative will contact you shortly:

First Name	Last Name

Name of Practice

Title/Position

Street Address

City

State	Zip

Telephone number where we may contact you

Preferred time to contact you (Eastern Standard Time)