Orthoplex White Label Agreement NZ

Orthoplex White Label is a Clinical-Grade Supplement Range, and undergoes extensive 3rd party batch testing and substantial quality assurance controls. This range leads the industry in purity, transparency, and innovative research - Due to the high requirement of clinical prescibing knowledge for this range, it is restricted to practitioners who adhere to the Orthoplex White Label Selling Standards(PDF).

Orthoplex White Label Prescribing

* Indicates required field

YOUR ACCOUNT NAME: *

Prescribing Practitioner Details:

The liable Practitioner for all White Label prescriptions & Audits.
Best Practice is one form per prescribing practitioner.

Practitioner First Name *

Practitioner Last Name *

Highest Relevant Qualification: *

Conditions of Supply:

1. The practitioner/s working in the clinic have nutritional qualifications, or meets the criteria for prescribing as outlined in the Orthoplex WL Agreement.
2. A consultation will be conducted only by an approved healthcare practitioner.
3. The Clinic has an enclosed or dedicated seating area where a private consultation can take place.
4. All patients are given written directions on how to use dispensed products.
5. Products will not be dispensed without a consultation as per industry standard guidelines and/or valid script from an approved healthcare practitioner. Shop floor or over the counter consultations will not be accepted as a consultation. Any walk in patients require a full consultation.
6. Products will not be dispensed for an invalid script
7. Patients will be given verbal instructions about what to do in the event of an adverse reaction
8. Products will be inaccessible and non-visible to the general public if stored in a retail area
9. Products will not be sold online unless in a password protected area for current patients only with no visibility of products or product information to the general public. A questionnaire alone will not qualify as a consultation.
10. Each individual agrees to inform ProHerb in the event that the practitioner leaves, or any of the circumstances above change which would effect this agreement.
11. I have read the full Selling Standards document and will endeavour to abide by all selling rules and processes.

Your Declaration:

BY SUBMITTING THIS FORM, I CONFIRM THAT AS THE PRESCRIBING PRACTITIONER,

I AGREE TO THE ORTHOPLEX WHITE LABEL SELLING STANDARDS, AS INDICATED ABOVE, AND CAN CONFIRM THAT THE INFORMATION SUPPLIED IS ACCURATE & TRUE *

I AGREE TO THE WHITE LABEL SUPPLY TERMS

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