CytoplanUSA Wholesale Application Form

Online Signup Process

Click the "Get Started" button to begin.

This process should take less than 5 minutes!

CytoplanUSA Terms & Conditions
- Except as otherwise noted, these terms and conditions apply to all products in the CytoplanUSA product line.
- CytoplanUSA offers wholesale pricing to those that are identified by CytoplanUSA, at its sole discretion, as either licensed healthcare practitioners or approved retail healthcare product distributors.
- CytoplanUSA suggests a licensed practitioner be available for email/phone consultations in the event that a customer purchasing a product from the website has questions or concerns. CytoplanUSA will not provide medical advice or guidance of any kind to any customer.
- No Product discounting is permitted. All Products must be priced at or above Suggested Retail Price (SRP) as defined per CytoplanUSA’s current Price List.
- Products may be sold on the Internet only through authorized websites whose URL has been provided to CytoplanUSA and only directly to patients and customers.
- CytoplanUSA ships to patients and practitioners in the United States only.
- All wholesale orders over $250 may be shipped requiring a signature by the recipient. While CytoplanUSA appreciates and values its customers, we cannot be liable or responsible for packages that are lost or stolen after being signed for and accepted.
- Account approval is Non-Transferable. As the seller, you must notify us if there is a change to the business name or owner, and we will determine at our sole discretion if the account may remain open.
- CytoplanUSA reserves the right to discontinue wholesale pricing to any account found to be in violation of the conditions listed herein. In the event that a violation has occurred, CytoplanUSA will provide the offender with a notice. If violations continue after receiving the notice, CytoplanUSA reserves the right to close the account and discontinue selling to the offender.
- CytoplanUSA reserves the right to modify this Agreement at any time, and without prior notice. Amended terms will be sent electronically to the email address on file
- Purchasing CytoplanUSA product constitutes your acceptance of these Terms and Conditions. You may request a current copy of the Terms and Conditions, at any time, by calling or sending an email to Support@CytoplanUSA.com.
Please Check:*

I agree to the Terms & Conditions. The information provided in this application is complete and accurate to the best of my knowledge.
Date

MonthDayYear

Client Information

*Required Fields
Full Name*

First NameLast Name
Phone Number*
Include area code
Website
Email*
example@example.com
Business/Practice Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Referral Code (if applicable)
Note: Products are only shipped to patients or health care providers in the United States.

Sales Taxes

Wholesale Exemption and When to Collect
Resellers may submit a Sales Tax Exemption Certificate so that you will not be charged sales tax on your purchases. In most states, sales tax should be collected when the first use of a taxable service occurs. For example, when a customer purchases the product in your office or when a customer purchases it from a retail establishment.

Please note that you are responsible to collect sales tax as required by your state, which may include non-wholesale orders and orders placed by employees for their own use. Consult your state's specific sales tax laws for further clarification, as many states assess fines, penalties and interest on unpaid sales taxes.

We are located in Missouri, so we can accept the Missouri Sales Tax Exemption Certificate or the Tax Exemption Certificate for your home state.

You can download the "Missouri Sales and Use Tax Exemption Certificate" here: [view certificate]

To find the certificate for your home state, search "[your state's name] Sales Tax Exemption Certificate". It will usually appear on your state's official website ending in .gov.
Once you've completed your tax certificate, you can take a picture or scan the document, save it to your computer and upload it below.

Additionally, you can email your certificate to support@cytoplanusa.com or fax it to 877-903-9290.
I will be reselling products purchased through this site and request a retail sales tax exemption. I understand that it’s my responsibility to collect and remit applicable sales tax to my state for products my patients purchase as may be required by law.
File Upload

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Account Settings

Used to login to CytoplanUSA.com
Your account login will be set up using your email address and a temporary password which we will send to you. If you have any questions about your login credentials, please email Support@CytoplanUSA.com or call toll free 844-691-4106.
License or Certification
Health care providers: Please submit a copy of you license or certification.

Retail resellers: Please submit a copy of your business license.

If you prefer, you may provide this later, but we must receive it before we will activate your wholesale account.

Options for providing license or certification:
1. Take a picture of it with your phone or device and email it to Support@CytoplanUSA.com.
2. Take a picture or scan document, save it to your computer and upload it below.
3. Fax it to 877-903-9290
File Upload

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Last Step — Just Click "Submit"!

When your form has been submitted, you will see a "Thank You" message.
support email for notification logic
example@example.com
Should be Empty:

Client Information

Sales Taxes

Account Settings

License or Certification