Submit a request

First Name

Please Enter same name as in reZen (don't include the middle name or initial here)

Last Name

Please Enter same name as in reZen (don't include the middle name or initial here)

reZEN Business Phone #

Phone # as seen in reZEN

Updating Current or Changing License #/Type

Please let us know whether you are renewing your current license or updating your license number and type with a new expiration date.

New Expiration Date of License

Please provide the updated expiration date of License

State or Province of License

Please choose the state of license

License Number

Please enter your License Number above. In the Attachments section below, upload one high-quality image or PDF of your new license clearly showing the license number and updated expiry date. Blurry or unclear documents may result in your request being rejected. THIS IS REQUIRED TO HAVE YOUR LICENSE UPDATED IN reZEN.