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Affiliate Application

Please download & read our Affiliate Terms of Service before submitting your application.

Your Name(Required)

First Last

Your Email(Required)

Phone

Business Name

Website

Social Media

What social networks are you on? Select all that apply.

Facebook

Instagram

Twitter

TikTok

Other

Do you work in allied health or have a health background?(Required)

List any health credentials, formal qualifications, association memberships etc.

Commission payout date will be on the 1st day of each month. Cutoff date for commissions earned is 30 days prior to account for customer refunds.

All commission payments are in AUD$(Required)

Account Name

Australian bank accounts only.

BSB

Account No.

Terms of Service(Required)

I have read and accept the Affiliate Terms of Service

Email
Password
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