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New Wholesale Customer Order
***If you are a retail customer, or a patient sent here by one of your practitioners, please complete your purchase by adding items to your cart and checking out. This order form is for wholesale/professional customers only***
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* Indicates required question
Email
*
Your email
Your name
*
Your answer
Phone number
*
Your answer
Business name
*
Your answer
Additional business contact (if different from above)
If anyone else will be handling future orders, please include their name, email, and phone number below.
If there is a different email address for invoicing, please enter below as well.
Your answer
Shipping address (street)
*
Your answer
Shipping address (city)
*
Your answer
Shipping address (state)
*
Your answer
Shipping address (zip code)
*
Your answer
Billing Address (street)
*
Your answer
Billing Address (city)
*
Your answer
Billing Address (state)
*
Your answer
Billing Address (zip)
*
Your answer
Preferred payment method
*
Credit/debit card
Direct deposit/ACH
Check
First Order
Available formulas
All formulas are available as bottles of 180 capsules (500mg each).
IMMUNE and BRAIN & NERVES are also available as jars of bulk powder (90g total).
LUNGS will be available as bulk powder in the future.
Prices
All units have an MSRP of $59.95. Wholesale orders are 50% off for a final unit cost of $29.98.
Payment terms
We now offer net 90 payment terms for first orders (payment is due 90 days from date of shipment).
Please inquire below if you have questions about payment, or would like additional time to complete payment.
Shipping
Shipping is free for order of 12 units or more.
We ship orders via USPS Priority Mail within 2 business days.
Select the number of units of each formula for your first order below.
*
0
1
2
3
4
5
6
IMMUNE (180 capules)
IMMUNE (90g powder)
BRAIN & NERVES (180 capsules)
BRAIN & NERVES (90g powder)
LUNGS (180 capsules)
0
1
2
3
4
5
6
IMMUNE (180 capules)
IMMUNE (90g powder)
BRAIN & NERVES (180 capsules)
BRAIN & NERVES (90g powder)
LUNGS (180 capsules)
Any additional information or questions?
Your answer
Next steps
After you submit this form, you will receive an order confirmation, an invoice with your payments terms, and shipping confirmation within 2 business days.
Order confirmation
*
I agree to the purchase terms above.
Required
A copy of your responses will be emailed to the address you provided.
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