LAUSD Wellness Programs

LIFE Program Authorized User Request Form

If you are with an LAUSD School, please use the form below. If you are NOT an Agent with an LAUSD School, please click here to be directed to the form for all other agencies.  For questions, contact lifeinfo@iilosangeles.org.

LAUSD Wellness Programs - LIFE Program Authorized Users
Agent's Name
Agent's Name
First Name
Last Name
I acknowledge that I have received, read and accepted the 2025-2027 LIFE Program Operating Guidelines, and agree to comply with the terms and guidelines of this document. (To view or download the document, please see the link below under the "Submit" button.)

2025-2027 LIFE Program Operating Guidelines