Practitioner Registration

A Health Practitioner Registration account provides wholesale account for all products and special programs to benefit your clinical practice. Health and Vitamin Stores can also use this form for us to get to know each other.  To apply submit your application below.

Please enter your website:

 

In order to set up your account, we need to receive a copy of one of the following items: certification or state license.

Option 1: Upload your certification, business or state license

 

Option 2:

Provide link to Licensing Board Website

List your License Number

 

Will you be reselling products outside your private practice?

If yes, where will they be sold?

Would you be interested in receiving information on our Patient Referral Link Program so that your patients can purchase products directly from us?

Area(s) of Focus/Interest (check all applicable):