Wholesale Account Application

Thank you for your interest in becoming an Ambaya Gold Health reseller!  Please fill out the form below and we'll get you into our system ASAP - usually 1 to 2 business days.  You should get an email confirmation, and account invitation.  Once you accept the invitation you should be able see your new discounts.

If you are a practitioner (don't have a reseller license) you can leave the reseller ID blank.  You will receive 20% off all physical products.

If you are a licensed reseller, please make sure to include your reseller license so that we don't charge you tax, and we can set you up for 30% discount all physical products.  

We're looking forward to doing business with you!