RockCuff Single Clinic BFRT Program

Single Clinic Membership Registration

Welcome to RockCuffs BFRT Program. Complete the form below to sign up for our BFRT Clinic Program.
Clinic*

Business NameOrganization Type: LLC, C Corp, S Corp, Partnership
Clinic Contact*

First NameLast Name
E-mail*
Best Email for Communications
Phone Number*

Area CodePhone Number
Clinic Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Clinic Program Option Details
Option 1A: Inventory in the Clinic using RockCuff Branded Cuffs: No minimum purchase requirements or subscriptions needed. Purchase of cuffs at a 25% discount, shipped to your clinic at no charge. The 25% discount will be your commission or you are free to give your patients a discount.

Option 1B: Inventory in the Clinic personalizing the Cuffs with your logo: Your first order must be for at least ten (10) sets of cuffs and subsequent orders must be for at least five (5) sets. A one-time charge of $150 will be applied. Purchase of cuffs at a 25% discount shipped to your clinic at no charge. The 25% discount will be your commission or you are free to give your patients a discount.

Option 2: The patient will order directly from RockCuff and will be charged shipping. You have the option of having the product shipped to your clinic or direct to the patient. You have the option of giving your patient a 20% discount or the clinic will receive a 20% commission. Sales will be reported and commissions paid within eight (8) days after the end of the month.
Select the RockCuff Program you would like to participate in. (You are free to change options at any time.)*

Option 1A: Inventory in Clinic 25% Discount, with RockCuff Branded CuffsOption 1B: Inventory in Clinic 25% Discount, with your logoOption 2: Patient Direct Order 20% Discount
If you chose Option 2: What discount would you like to give your patients? (This will come from your commissions.)

0%5%10%15%20%
Marketing Materials
What marketing tools would be valuable for you and your customers?

4 x 6 cards to give to patients (initial order of 250)Website imagesIn-office printed material (digital file)Social media tags
Upload your company logo

This will be used for marketing and/or the RockCuff Branding
File Upload (format for marketing: .jpg) (format for customization of logo on cuffs: .png with transparent background or a .psd with layers)

Cancelof
BFRT Certificate Course

The University of Tennessee Knoxville through Northeast Seminars
What clinician will be participating in the Free BFRT Certificate Course

First NameLast Name
Clinician's phone number
Please enter a valid phone number.
Clinician's email
example@example.com
Do you have other clinicians that would like to take the course for 20% off?

YesNo
If you answered yes, please type their names below.
Privacy Policy
Our Privacy Policy is located at https://www.rockcuff.com/terms. Check below to accept the policy.
Agree with Privacy Policy*

I have read, understood, and accepted the PRIVACY POLICY for membership.
Product Purchase

Wholesale Pricing - You will need Cuffs to participate in the BFRT Interactive Lab
RockCuffs
prevnext( X )
Clinic Set - Six Straps25% off Retail Price $449
$336.75



Pro Set - Four Straps (Arm + Leg)25% of Retail Price $289
$216.75



Large - Basic Set - 2 Straps25% off Retail Price $169
$126.75 Quantity
Item subtotal:$0.00



Medium Basic Set - 2 Straps25% off Retail Price $169
$126.75 Quantity
Item subtotal:$0.00



Small Basic Set - 2 Straps25% off Retail Price $169
$126.75 Quantity



Subtotal

$0.00

Tax

$0.00

Shipping

$0.00

Total

$0.00
Pay with PayPal

Please click one of the PayPal options to complete payment and submit the form.
Once you submit your application, we will contact you shortly to provide you with the tools you need to make this a successful venture.

Thank you!
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Single Clinic Membership Registration

Clinic Program Option Details

Marketing Materials

Upload your company logo

BFRT Certificate Course

Privacy Policy

Product Purchase