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Medical & Chiropractic Practice Partner Agreement

Greetings! We are excited to be joining forces with you to advance wellness through functional food and nutrition. Please review our program overview here. Use the form below to register your medical practice as a revenue-sharing partner with MyFormulary. Please download, read and retain a copy of our Partner Agreement here. You will be asked to acknowledge receipt and acceptance of terms at the end of the form below.

Master Partner Registration

Please complete the six required fields below (and any additional fields you wish) and one of our Partnership Experts will contact you to schedule a discovery call to fully understand your needs and create a solution to meet them.

Part A - General Information

Part B - Biographical Information

Part C - Co-Branded Landing Page Information

Part D - About Your Practice

Part E - Confidential Financial Information

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