wholesale application Form - The Hemp Doctor Wholesale

Apply to Be A Hemp Doctor Wholesaler

Fill out the form below to register an account to be a Hemp Doctor Wholesaler.

If your state requires you to have a Tobacco/Nicotine license, you must include that license here.

Wholesale Application

Your account

This is the login you will use to place wholesale orders.

Name

First

Last

Username

Password

Enter password

Confirm password

Your business

Business Name

Business Address

Please enter your business address. Using a personal address may slow down your approval process.

Street address

Address line 2

City

State / Province / Region

ZIP / Postal code

Country

Phone

Website

EIN

Tobacco / Nicotine licence

Only if your state requires one. Enter the number, upload a copy, or both - and if you do not have it to hand, you can send it to our team after applying.

Licence number

Optional - if you know it.

Upload a copy

Choose a file or drop it herePDF, JPG, JPEG, PNG · max 10 MB

Optional - PDF, JPG or PNG.

Products you are interested in

Almost done

Referral Code

Were you referred by someone? Enter their code.

Message (Optional)