Apply for a Wholesale Account

Wholesale Account Application

Complete the application below to open your wholesale account. All fields are required unless marked optional. Takes about three minutes.

About You

Which best describes you?

First Name

Last Name

Email Address

Phone Number

Your Business

Company / Practice Name

Company Website (optional)

Company Phone

State of Registration

The state where your business is legally registered or incorporated.

National Provider Identifier (NPI)

Resale Tax ID (EIN)

Enter your NPI or your Resale Tax ID (EIN). At least one is required. Enter both if you have both.

Business Address

Address Line 1

Address Line 2 (optional)

City

State / Province

ZIP / Postal Code

Country

Consent is not a condition of purchase. Message & data rates may apply. Message frequency may vary. Reply STOP to opt out of messages at any time. Reply HELP for assistance. You must be 18 years of age or older to use this SMS service.

By submitting this form, you agree to our Privacy Policy and Terms of Service.

Application Received

Thank you for your interest in oral dissolving peptides. We will review your application and be in touch within 1-2 business days. Check your email and phone for updates on your wholesale account approval.

Get in Touch

Phone: (737) 379-0933
Email: [email protected]
Hours: Mon-Fri 9:00 AM - 5:00 PM CT

What Happens Next?

After you submit your application, our Clinic Launch Lab team at Elite DCS LLC reviews your information. Most accounts are approved within 1-2 business days.

Once approved, you will receive access to the full wholesale catalog and can place your first order immediately.