Wholesale Application Form

To apply for a wholesale account with Superior Source Vitamins, please fill out the form below. A customer service representative will contact you shortly.

Already a customer but haven't ordered online before? Please call our customer service at 1-800-421-6125 and we'll set you up with an online account right away!

    • Submit Your Business Information

    • Required fields marked with asterisk (*)
    • *
    • *
    • Type of Business (check all that apply)*
    • Business Info
    • *
    • *
    • Contact Info
    • *
    • *
    • Billing Address
    • *
    • *
    • *
    • *
    • *
    • Shipping Address

*Disclaimer: The statements made on this web site have not been evaluated by the Food and Drug Administration. The products featured are not intended to diagnose, treat, cure or prevent any disease. Any medical concerns should be directed to a qualified health consultant.