AFFILIATE REGISTRATION FORM

Our Affiliate Program is designed for independent or private practices only who specialize in pelvic muscle rehabilitation and would like the benefit of a world-class distribution channel; without the expense or space to maintain one. PelvicTech, a business leader specializing in pelvic muscle rehab products and services will fill your patients orders so there is no guess-work from you!

What are the benefits? Well, in addition to being the fulfillment agent for the products you typically refer to your patients, PelvicTech will provide the facility with a referral fee based on the products sold through your unique landing page which we will create for you and you will embed onto your website. To get started, simply fill out the form below.