BECOME A HEALTH ESSENTIALS PARTNER

Company Name *

Your Name *

Email *

Phyiscal Location Address *

City *

State *

HEALTHCARE VERIFICATION

Selling CBD CLINIC™ products - or puchasing a BioMat® with a Professional Discount - requires a copy of your current healthcare license. You can upload a copy below, or email a copy with your application to info@hecandi.com

All other product lines – Charlotte’s Web, CBD Medic, Jawku, Bucky and BioMat’s without a Professional Discount - are available for sale without a healthcare license.

TYPE OF BUSINESS (*Requires copy of Healthcare License) *

Healthcare-Acupuncturist*
Healthcare-Dental Office*
Healthcare-Massage Therapy*
Healthcare-Medical Office*
Healthcare-Physical Therapy*
Healthcare-Podiatrist*
Hotel/Inn
Pet Store
Pharmacy
Retail-Healthy Lifestyle
Retail-Other
Spa/Salon
Sports-Golf Course
Sports-Team
Sports-Tennis Center
Other (please describe below)

Healthcare verification to sell CBD CLINIC products - or to purchase a BioMat with a Professional Discount - will require a copy of your current healthcare license.

You can also email a copy with your application to info@hecandi.com

Other

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Bucky®