EmailMeForm
ProHealth Partner
When you are ready to join forces with the ProHealth Diet, please fill out the following information. Please allow 24-48 hours for it to be reviewed.
Name
First
Last
Today's Date
MM
/
DD
/
YYYY
Email
Phone
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What is the name of the business you currently own or operate?
How long have you been involved with your current health-related business?
How many employees does your business currently have?
Do you have multiple business locations?
Yes
No
Not yet
Health Facility Main Location:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Did you go through the income documents on your own or with a ProHealth Team member?
I reviewed the plan options by myself
I reviewed the plan options WITH a ProHealth team member
Both
Which partnership level interests you the most?
Silver
Gold
VIP
Wholesale Only
What are your goals (both financially and non-financially) by partnering with ProHealth? This is where we get to discover if our goals are in sync with each other and if we would be a good fit to move forward in business together. Please elaborate and be as honest as possible.
What best describes your current attitude regarding partnering with ProHealth?
I am very cautious and will maybe try to get a few dieters.
I can see this could really benefit my business and am willing to give it my best effort.
I can see this is HUGE and am very excited! Tell me what I need to know to succeed.
How soon would you like to get started?
To be considered, you must agree and understand the following terms. You will be disqualified should you disagree with any one as each are important to the success of this relationship. Please understand and agree to the following:
I understand ProHealth Diet is a licensed, trademarked company with all copyrights legally reserved. All ProHealth Diet videos, app and all ProHealth Diet material are the property of ProHealth Diet and may not be used away from ProHealth.
I understand ProHealth food purchased will not be refunded or returns accepted unless product arrived damages during shipping.
I promise to use ProHealth Diet in a respectable manner, always putting the dieter first.
I promise my team will follow the instruction of the ProHealth CEO Coaches to the best of our ability. If we are not running the program how it was designed, all coaching privileges may be removed. This is for the safety of the dieter.
I understand I will be paid directly from ProHealth for my referral thank yous.
I understand I will be given the necessary tax forms and will be responsible to pay our own taxes on money sent from ProHealth.
I understand this partnership can be terminated immediately in the event actions do not protect the ProHealth brand, comply with or properly promote the goals of the company. ProHealth reserves the right to determine this partnership.
We are almost done! Do you have any immediate questions or concerns we can help you with?
My checking YES, I agree everything on this application is true to the best of my knowledge. I also agree to all the term and conditions of the program (as listed above). I acknowledge checking YES binds me to these agreements.
Yes
No
After this is reviewed and a decision has been made by our ProHealth Team, what is the best way to contact you? We will be in touch as soon as possible (even if we discover we are not a good business match). Thank you for your interest in ProHealth! We look forward to potentially working with you in the near future!