A01_PRO Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 10Name *FirstLastRelation To Business/Title? *OwnerPartnerOffice ManagerStore/Inventory ManagerOtherNextBusiness Location(s)Business Name *What Country Are You Located In? *United StatesAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAustrian Empire*AzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBenin (Dahomey)BoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina Faso (Upper Volta)BurmaBurundiCabo VerdeCambodiaCameroonCanadaCayman Islands, TheCentral African RepublicChadChileChinaColombiaComorosCosta RicaCote d’Ivoire (Ivory Coast)CroatiaCubaCyprusCzechiaDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlands, TheNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic of Korea (South Korea)Republic of the CongoRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon Islands, TheSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab Emirates, TheUnited Kingdom, TheUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabweLayoutStreet Address 1 *Street Address 2City *State / Province *ZIP/ Postal Code *NextCommunicating With You BestLayoutBusiness Phone *Your Cell *Email *NextAbout Your BusinessHow many business locations do you have? *How would you categorize your business? *Select an optionHealthcare PracticeNatural MedicineFitness/ExerciseWellness PromotionOrthomolecularPharmacyHealth Food StoreBeauty AdvisorTelemedicine ProviderAcupunctureMassage TherapyOtherWhat type of practice is it?Select an optionFamily PracticeCardiologyGastroenterologyMental HealthChiropracticDentalNeurologyOB/GYNNephrologyImmunizationPain ManagementInfectious DiseaseOncologyGeriatricSurgeryHormonal HealthAllergy / ImmunologyWellness CenterOccupational TherapyBariatricsDialysisEmergency ServicesEndocrinologyENTHospitalHospitalistInternal MedicineNursing HomeOrthopedicPediatricPersonal HealthPhysical TherapyRheumatologySleep MedicineWeight ManagementOtherNextFormula Interest RnA ReSet offers 4 categories of Completement Formulas developed by Carolyn Dean MD ND. This unique collectiion of vitamins, minerals, and specialty nutrients were developed to be highly-absorbed while providing the core building blocks the body needs to function at its best. Please select what categories of formulas you are planning to include in your own nutrient protocols to help us build a custom onboarding program just for you.Completement Formulas *Liquid MineralsNutrient CapsulesSkin CareSpecialty Nutrients Liquid MineralsLiquid MineralsReMag MagnesiumInterestedNot InterestedNeed More InfoReMyte Mineral SolutionInterestedNot InterestedNeed More InfoReCalciaInterestedNot InterestedNeed More InfoPico PotassiumInterestedNot InterestedNeed More InfoPico ZincInterestedNot InterestedNeed More InfoPico SilverInterestedNot InterestedNeed More InfoPico SeleniteInterestedNot InterestedNeed More Info Nutrient CapsulesNutrient CapsulesReAline Nature's DetoxInterestedNot InterestedNeed More InfoWhole C ReSetInterestedNot InterestedNeed More InfoFlora ReViveInterestedNot InterestedNeed More InfoD3K2 ReSetInterestedNot InterestedNeed More InfoOmega 3 Algae A+EInterestedNot InterestedNeed More Info Skin CareSkin CareReMag LotionInterestedNot InterestedNeed More InfoReMag BalmInterestedNot InterestedNeed More InfoFlora ReFresh SprayInterestedNot InterestedNeed More InfoReNew Face CreamInterestedNot InterestedNeed More InfoReNew Skin SerumInterestedNot InterestedNeed More Info Specialty FormulasSpecialty NutrientsReStructure Protein PowderInterestedNot InterestedNeed More InfoVitamin C ReSetInterestedNot InterestedNeed More InfoRnA ReSet DropsInterestedNot InterestedNeed More InfoNextPromoting Your Business: WebsiteDo you currently have a website? *NoYesWhat is your current website address? (copy)How is your website supported?OwnerInhouse StaffOutsourcedFamily/FriendOtherHow much do your marketing efforts rely on your website? Selected value: 0 Do you have a blog on your website?YesNoDo you have an online store?YesNoWhich ecommerce platform do use?ShopifyWooCommerce (WordPress)SquarespaceWixMagentoGoDaddyUnsureNextPromoting Your Business: Social MediaAre you promoting using Social Media? *NoYesLayoutHow much do your marketing efforts rely on Facebook? Selected value: 0 How much do your marketing efforts rely on Instagram? Selected value: 0 How much do your marketing efforts rely on Twitter? Selected value: 0 How much do your marketing efforts rely on YouTube? Selected value: 0 How much do your marketing efforts rely on LinkedIn? Selected value: 0 NextPromoting Your Business: EmailAre you promoting using Email? *NoYesHow much do your marketing efforts rely on email? Selected value: 0 What email platform do you currently use for marketing?NextCustomizing Your PartnershipLayoutAre you interested in the Onsite Store program? *InterestedNot InterestedThis model includes deeper discounts, marketing support, and access to special resources for maintaining product inventory at your business location.Are you interested in the Doctor-To-Door program? *InterestedNot InterestedSharing of links on your website, within social media posts, or as part of your email sends as you engage with your customers digitally. This model provides a seamless drop-shipping service directly to your clients with a large investment in technology or resources on your part.How would you hope that the program(s) will benefit your practice? *NextFinal Questions Before SubmittingAny questions/comments that you have that you would like to discuss with the RnA ReSet' PRO team?Submit
