Dealer Inquiries

The following expectations are designed to ensure that as a Back on Track Authorized Reseller, our partnership produces the necessary outcomes that we value in such partnerships. Passion, commitment, transparency, knowledge of the brand, adherence to our retail pricing policy, and an overall commitment and respect for the customers you serve.

Retailer Application (Brick & Mortar/Ecommerce)
Practitioner / Retailer Application
Practitioner Affiliate Program

Dear Retail Applicant

Thank you for your interest in Back on Track.

At Back on Track, we value our vendor partnerships. Passion, commitment, transparency, knowledge of our brand, adherence to our retail pricing policy, and an overall commitment to the customer are the driving forces in our vendor partnership successes.

To this end, Back on Track asks that all questions in our Retail Application be answered. Our goal is to make sure that the when we approve an applicant and provide the applicant with the moniker of ‘Approved Authorized Back on Track Dealer’, both the vendor and Back on Track have clear expectations of what the vendor partnership requires.

Applications are reviewed weekly. If you do not hear back from us fourteen (14) days after the date of submission, your application has been denied.

Thank you for your interest in Back on Track and if approved, we look forward to developing a strong vendor partnership.

Respectfully,

James S Ruder
CEO / Managing Director
Back on Track USA

Date(Required)

Legal Business Name(Required)

Type of Business Entity(Required)

Owner Name or Name of Primary Principal(Required)

First Last

Contact Name(Required)

First Last

Position

Billing Address(Required)

Street Address City State ZIP Code

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Shipping Address

Street Address City State ZIP Code

Phone(Required)

Extension

Fax

Email(Required)

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Website

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Facebook

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Phone

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Signature

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Is Physical Location Different?

Yes

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Fax

Store Type(Required)

Online

Brick and Mortar

Please upload an image of your storefront(Required)

Accepted file types: jpeg, jpg, png, pdf, Max. file size: 100 MB.

Online Store URL(Required)

Type of Business

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Brick and Mortar

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Chiropractor

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Therapist

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Other Business Type

Resale# / License# or Certificate#

Federal ID# (Tax# or EIN#)

Retail Stores: Please upload a copy of your Resale Tax Certificate when submitting your application.

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 100 MB.

Tell Us About Yourself

Number of stores(Required)

Number of employees(Required)

Number of years in business(Required)

Approx. annual gross sales(Required)

Do you sell on 3rd party resale platforms?(Required)

Yes

If yes, please list them

List 3rd party resale platforms

Please name other high-value brands that you sell.

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Doctors/Therapists: Please provide a copy of your Business License and Resale Tax Certificate to avoid sales tax.

Max. file size: 100 MB.

Trade Credit References

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Company Name - Reference 1

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Contact Name

First Last

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Terms

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Credit Limit

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Address

Street Address City State / Province / Region ZIP / Postal Code Country

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Phone

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Fax

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Company Name - Reference 2

Hidden

Contact Name

First Last

Hidden

Terms

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Credit Limit

Hidden

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Hidden

Phone

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Fax

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Company Name - Reference 3

Hidden

Contact Name

First Last

Hidden

Terms

Hidden

Credit Limit

Hidden

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Hidden

Phone

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Fax

RETAIL PRICING POLICY

BACK ON TRACK is proud to be represented in quality retail outlets throughout the United States and is committed to providing excellent service and support to our retailers as well as top quality products to your customers. To maintain that level of quality and service, to encourage demand for our products, and to offer the opportunity for retailers to profit from sales, BACK ON TRACK believes that fair and reasonable pricing is necessary to both the retailer and to BACK ON TRACK.

It is therefore BACK ON TRACK’s policy that its products be advertised, offered, quoted, and/or priced at the minimum suggested retail price by all retailers. BACK ON TRACK will publish its minimum suggested retail prices annually. The minimum suggested retail price guidelines will be emailed to all retailers and will also be available on our wholesale website portal at www.wholesale.backontrackusa.com. Retailers are expected to comply with published prices immediately and to make any price adjustments within ten (10) business days from date of publication.

By virtue of placing orders and receiving shipments of Back on Track products, you agree to abide by our Retail Pricing Policy. Violation of this policy gives BACK ON TRACK the right to suspend further sale of products to your business at their sole discretion

I have read and will abide by the Back on Track Retail Pricing Policy. INITIALS OF AUTHORIZED PERSONNEL:(Required)

Signature(Required)

CAPTCHA

This application is only to be completed by licensed Veterinarians, Medical Doctors, Chiropractors, Physical Therapists, Physiatrists, and others who provide professional health care services. In support of these important services, we allow approved practitioners the ability to stock and sell products.

Legal Business Name(Required)

DBA

Practice Type :(Required)

Veterinarian - Large

Veterinarian - Small

Practitioner - Acupuncturist

Practitioner - Chiropractor

Practitioner - Licensed Massage Therapist

Practitioner - Medical Doctor

Practitioner - Physical Therapist

(choose the one that best describes your practice)

Billing Address(Required)

Street Address City State ZIP Code

Is Shipping Address Different?

Yes

Shipping Address(Required)

Street Address City State ZIP Code

Website

Phone(Required)

Federal ID# (Tax# or EIN#)(Required)

Contact Person

Contact Name(Required)

First Last

Position

Email(Required)

Phone(Required)

Extension

Please provide a copy of your Business License and Resale Tax Certificate

Accepted file types: pdf, png, jpg, jpeg, txt, doc, docx, Max. file size: 100 MB.

RETAIL PRICING POLICY BACK ON TRACK is proud to be represented in quality retail outlets throughout the United States and is committed to providing excellent service and support to our retailers as well as top quality products to your customers. To maintain that level of quality and service, to encourage demand for our products, and to offer the opportunity for retailers to profit from sales, BACK ON TRACK believes that fair and reasonable pricing is necessary to both the retailer and to BACK ON TRACK.It is therefore BACK ON TRACK’s policy that its products be advertised, offered, quoted, and/or priced at the minimum suggested retail price by all retailers. BACK ON TRACK will publish its minimum suggested retail prices annually. The minimum suggested retail price guidelines will be emailed to all retailers and will also be available on our wholesale website portal at www.wholesale.backontrackusa.com. Retailers are expected to comply with published prices immediately and to make any price adjustments within ten (10) business days from date of publication.By virtue of placing orders and receiving shipments of Back on Track products, you agree to abide by our Retail Pricing Policy. Violation of this policy gives BACK ON TRACK the right to suspend further sale of products to your business at their sole discretion

I have read and will abide by the Back on Track Retail Pricing Policy. INITIALS OF AUTHORIZED PERSONNEL:(Required)

Signature(Required)

CAPTCHA

Our exclusive Back on Track Practitioner Affiliate Program provides practitioners who have an active Back on Track Wholesale Account with an additional income stream. This program can provide excellent referral income when incorporated into your practice. ONLY AVAILABLE TO LICENSED VETERINARIANS, MEDICAL DOCTORS, CHIROPRACTORS, PHYSICAL THERAPISTS AND PHYSIATRISTS.

Become an Authorized Retailer

Type of Business

Tell Us About Yourself

Trade Credit References

RETAIL PRICING POLICY

Contact Person