BabyB, that's so sad... my bmi was under 40 but still had to send form off & cdc kept hassling me & him until he'd signed form & returned it... so maybe you still need signature anyway? Could you go and see him & ask why he has refused? Failing that, ask to see a different doc i the practice and keep fingers crossed, or do as Vamp suggests and do SS+ as results sound just as amazing on this. I'm so sorry, it must be such a disappointment!