Distributor Forms

Instructions:

Click the blue hyperlinks to download each form. 

1.) Return the signed HYD Distributor Agreement to [email protected], or via fax at 877-550-1931.

HYD Distributor Agreement

2.) Return the completely filled out Distributor Intake Form and ACH form to [email protected], along with a copy of your voided check or bank letter.

Distributor Intake Form

ACH Debit Form

OPTIONAL: If interested, sign up for HFA here.

3.) Upload your patient database (name, phone, and email) to Sionis Marketing. Make sure that your clinic name or provider name is listed in the file name. 

Secure upload link – click here.

Questions? Schedule a call with Michelle here. 

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