Practitioner Application.

*Active is defined as healthcare professionals who are currently
seeing patients and clients and who are caring for their personal
health needs. In the event of the qualifying professional’s
retirement, all purchase rights and benefits of the rebate programs
will continue. In the event of the death of the qualifying
professional, all purchase rights and benefits of the rebate
programs will transfer to the named beneficiary as listed on this
application. In the event of bankruptcy or insolvency of the
qualifying health care professional, all purchase rights and benefits
from rebate programs will immediately terminate.

**State laws may vary. Void if not legal in your state.