Healing BiologixInnovating Health Solutions

For clinics & providers

Pharmacy sign-up form

Tell us about your practice. We verify your NPI and licensing before activating wholesale pricing — most accounts are reviewed within one business day.

1Medical office information
Practice name / DBA
Primary order contact *
Office manager
Accounts payable
2Physician information
Physician #1
3Authorization

By signing this form, you authorize Healing Biologix to communicate with your practice via current methods including, but not limited to, fax, email, phone, and mail to share order updates, industry information, and/or marketing messages. Your contact information will not be shared, and opt-out options are available for marketing communications.

Already approved?