Affiliate Sign Up
Name
Email (So we can reply back to you)
Company Name
Website
Social Handles
Are you a Practitioner?
Yes
No
What is your practice modality?
Pick all that apply
DC
DO
MD
DDS
PharmD
RN
NP
PA
PhD
ND
PT
LAc
OT
Nutritionist
CN
RD
Other
What is your practice modality? (Other)
What is the size of your practice?
Number of Employees/Staff; Estimated Number of Patients
Do you currently have a wholesale account?
Yes
No
Are you interested in setting up a wholesale account to carry BodyHealth, LLC products in your office?
Yes
No
Do you have an ecommerce website?
Yes
No
Ecommerce Website
Do you sell on Amazon or other similar sites?
Yes
No
Amazon Store URL
Do you currently take BodyHealth products?
Yes
No
Which do you take?
What's your favorite BodyHealth Product?
Why do you want to be a BodyHealth affiliate?
Submit your application
Submit your application