Wholesale Inquiry

Thank you for your interest in the BrainMD Wholesale Partner Program!

To join our growing network of business owners and healthcare professionals pioneering brain health, wellness, and BrainMD nutraceuticals, and enjoy substantial savings on bulk purchases of select BrainMD products, please fill out and submit the form below.

All resellers must agree to the BrainMD Wholesale Terms and Conditions

PLEASE NOTE:
BrainMD does not accept international, ecommerce based, or online marketplace wholesaler or distributor partners at this time.

Contact Person Name*

First NameLast Name

Contact Person Email*

Confirmation Emailexample@example.com

Contact Person Phone*

Please enter a valid phone number.

Business Name*

Business Website*

https://yourdomain.com

Number of Years in Business*

What Best Describes Your Business?*

If "Other", please explain

Business Address*

Street Address

Street Address Line 2

CityState

Zip Code

Please tell us more about your business and how you plan on promoting BrainMD products.*

Any specific questions for us?*

How were you referred to BrainMD?*

I understand that BrainMD does not accept international, ecommerce based, or online marketplace wholesaler or distributor partners at this time.*

Type "I UNDERSTAND" in the above field.

Please verify that you are human*

Thank you for your interest in the BrainMD Wholesale Partner Program!

PLEASE NOTE:BrainMD does not accept international, ecommerce based, or online marketplace wholesaler or distributor partners at this time.

PLEASE NOTE:
BrainMD does not accept international, ecommerce based, or online marketplace wholesaler or distributor partners at this time.