Partner Registration

Thank you for choosing to open an account with Garden of Life. To establish an account with us, we ask that you:

  1. Have a License or Certification in a health modality
  2. Submit all of the following documents
    1. Professional License / Certification
    2. State Resale License
    3. Photos of treatment room, building, and supplement display area
  3. Email everything to or fax it to 866-465-0034
Contact Information
Customer Name *

Business Name * Phone *

Email * Fax *

Mailing Address * City *

State * Zip *

Shipping Address (if different) City
State Zip

Bussiness information
Type of Business
Practioner Other
Type of Business *

Resale Number * Business License Number *

Reffered By: (How di you hear about us?)
Magazine Physician Trade Show Other
Please Specify

Method of Payment

All orders processed by Garden of Life will be billed via credit card or C.O.D.

IMPORTANT NOTE: Please do not submit your credit card information via this online form.

After submitting this form, you will be contacted by one of our customer service representatives to take your initial order and credit card information.

Accounts Payable Contact * Authorized Signature *

By submitting this form, I Recognize And Accept The Conditions Shown Above And Certify That All Information Listed Is Correct And Accurate.