Pinxav

About Us

Our Story | Contact Us | Retailers Wanted

Retailers Wanted
.......................................................

Thank you for your interest in selling Pinxav.
We will be happy to provide you with the information you need to become a Pinxav Retailer and join the many independent drugstore owners, pharmacists, retail outlets and nursing homes who currently sell Pinxav directly to the consumer. To receive more information about selling Pinxav, please fill out this form to get started. Or if you need immediate info? Call Us Now at 888.4.pinxav (888-474-6928).

Thank you for your interest.

FIELDS MARKED WITH * ARE REQUIRED!

Name of practice or retail store?:*

Contact Name:*

Address:*

City :*

State:*

Zip:*

E-Mail Address:*

Phone:*

Ext:

Fax:

How many patients/ customers do you get who need a diaper rash ointment per month?:

How many patients/ customers do you get who need a diaper rash ointment per month?:

Where did you hear about Pinxav? :

May we call you in the future with product information? :

When done, please or

{ Retailers Wanted } { Links } { About Us }

{ Contact Us } { Affiliate Program }