Wholesale Application

If you are a health care provider and would like to order on-line, please fill out the following form, submit it, and we get back to you regarding simple on-line ordering instructions. After you receive our reply, please use your ID and Password to place your order. If orders are received before 10:00 AM, PST, they are shipped the same day.

*Dr. Dale does not share your name or her mailing lists with any organization other than her main distributor who will be mailing your information.

Name

First Name

Last Name

Phone

(###)

###

####

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Seller's Permit

Practitioner Type

Title

Website

Tell us about your practice

Notes

Disclaimer

I confirm that I am a health care provider desiring to order the Wellness Center's products at wholesale cost. I agree not to sell any of the Wellness Center's products on the internet.

Owned & Operated by DMD Natural Medicine
4834 NW 2nd Ave #102
Boca Raton, FL 33431
1-800-966-8181
support@drdalewellness.com

Terms of Service
Privacy Policy
Contact Us
Practitioner Map

FDA DISCLAIMER - These statements and any information contained on this website have not been evaluated by the Food and Drug Administration. This information is intended for educational purposes only and is not meant to substitute for medical care or to prescribe treatment for any specific health condition. These products are not intended to diagnose, treat, cure or prevent any disease. Consult individual product labels for safety information.

THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE - The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.