I started mine on August 30th, and I'm having surgery, September 23! I was told overseas that I just need to have two qualifying conditions (mine are, depression and High Blood Pressure) to be able to do it without Nutrition training and Psych Evaluation. I did however go to the HAWC overseas before we moved back to the U.S. two months ago and they used that as doing the nutrition/work out portion. It is a long process to finally GET the referral but once you have it, it's like gold and it will get you in as soon as you're ready for it!