Potential Vendor Product Form

Are you interesting in distributing your product through Performance Health? If so, please fill out the following form to express your interest.

Section 1: Company Profile

Name*

Title*

Company*

Company Address*

Phone*

Email Address*

Are you the manufacturer, a manufacturer rep, or distributor?*

Are you a new or existing vendor?*

New

Existing

Current Sales Model*

(Do you sell direct? Through distribution?)

If distribution, who do you currently distribute through?

Which products are you interested in Performance Health Distributing?*

How long has this product been in the marketplace? When was your initial product launch?*

Additional Notes or Comments

File Attachments

Please attach any additional files*. *You may attach up to 30 MB per file, 10 files per form submission. Files exceeding this limit will result in a error preventing your submission from being delivered. To submit additional files, please upload your files to a file sharing service such as WeTransfer or Dropbox and provide the link in the notes section.

Drag and drop files here or

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