PuraWell Wholesale Application

PuraWell Wholesale Account Online Signup

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This process should take less than 5 minutes!

PuraWell Terms & Conditions Agreement
- PuraWell offers wholesale pricing to those that are identified by PuraWell, at its sole discretion, as either licensed healthcare practitioners or approved healthcare product distributers.
- PuraWell products may be sold on the internet only through authorized websites whose URL has been provided by PuraWell and only directly to patients and customers.
- No product discounting is permitted. All products must be priced at or above Suggested Retail Price (SRP) as defined per PuraWell's price list.
- PuraWell suggests a licensed practitioner be avialable for email/phone consultations in the event that a patient purchasing a product from the website has questions or concerns. PuraWell will not dispense medical advice to any customer.
- PuraWell products are not to be displayed or offered for sale to the general public on open shelves in retail stores.
- Products may be displayed and sold through medical practices to patients or at retail pharmacies behind-the-counter.
- PuraWell 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 occured, PuraWell will provide the offender with a notice. If violations continue after recieving the notice, PuraWell reserves the right to stop sales to the offender.
- PuraWell reserves the right to modify the agreement at any time and without prior notice. Amended terms will be sent electonically to the email address on file. Continuing to order product constitutes your acceptance of the amended agreement. Account holder may request a current copy of the Terms and Conditions at any time by calling or sending an email to CustomerService@PuraWell.com .
- All orders will be shipped requiring a signature by the recipient. While PuraWell appreciates and values its customers, we cannot be liable or responsible for packages that are lost or stolen after being signed for and accepted from the shipper.
ACKNOWLEDGEMENT:

In witness therof, the parties hereto understand and will comply with this Terms & Conditions Agreement effective the date set forth below.
Full Name *

First Name Last Name
Degree/Credentials:
(Include all - MD, ND, DC, ect.)
Title *
Date *

Month Day Year
Please Check: *

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

Additional Information

*Required fields
Business/Practice Name *
Practice Website
(example www.samplesite.com)
Phone Number *

Area Code Phone Number
E-mail: *
Address *

Street Address

Street Address Line 2

City State

Zip Code
Country *
Accessing Your Account

VERY IMPORTANT -- PLEASE READ CAREFULLY!

After completing this form, create an account at www.purawell.com by clicking the Register link at the top of the page.

Initially you will see retail pricing when logging in. Once this wholesale account application is approved, we will notify you by email, and you will then see wholesale pricing.

If you have any questions, please email CustomerService@purawell.com or call toll free 888-PURAWELL (888-787-9355).
Website:
E-mail (if different than above)
Password *
Min 6 Characters
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