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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. For your reference, download a mock landing page outline here and complete as many sections as you like. We will have a one-on-one onboarding call to give you our advice and discuss best practices for program success. We will also provide you with a partner contract to secure your legal rights in this relationship. You can review our Partner Agreement here.

Medical Practice Registration

Part A - General Information

Address
City
State/Province
Zip/Postal

Part B - Biographical Information

Part C - Co-Branded Landing Page Information

Part D - About Your Practice

Part E - Confidential Financial Information

Staff section