Mama Mushroom International Inquiry Form
We are so happy you want to help us bring healthy benefits to people. Please share some information about yourself and your business, and we will be in touch shortly. Have a great day!
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Name of Business
Type of Business (select all that apply)

Geography (Region) Covered

Your Name


Email/Phone

Address 1

Zip code

City


State
Country
Website (optional)

Tell us about your business


How many locations do you have?
Do you sell online as well?
Clear selection
What are some of your favorite brands you carry?

Do you currently distribute functional mushroom brands?


Clear selection

Name the brands (if applicable)

Do you currently distribute supplement brands?


Clear selection
Name the brands (if applicable)
Tell us a fun fact about you and/or your business

What gets you excited about Mama Mushroom?

How did you hear about Mama Mushroom?  (select all that apply)
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