--- title: "Matt Marozick New Account" date: 2026-02-27 author: "Bonnie Rivas" --- # Matt Marozick New Account URLThis field is for validation purposes and should be left unchanged. First Name(Required) Last Name(Required) Email(Required) Business Name(Required)An established and active business is a requirement for requesting a wholesale account with Systemic Formulas. Tax ID Number or EIN Number(Required)If you do not have your Tax ID Number or EIN, you may alternately enter the last 4 digits of your SSN. Business Address(Required) Street Address Street Address Line 2 (optional) City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code How many practitioners are in your organization?(Required)Please enter a number from **1** to **50**. How long has your practice been open?(Required) Phone Number(Required)Please enter 10 digit phone number with no dashes, spaces, or special characters. By providing your number you understand and agree to the [SMS Privacy Policy](https://systemicformulas.com/sms-privacy-policy/), [SMS Terms & Conditions](https://systemicformulas.com/sms-terms-conditions/), and agree to receive communications from Systemic Formulas. Website or Primary Social Media How would you best describe your practice?(Required) In-person Virtual Both in-person and virtual Credential Type(Required)ACT - Colon TherapistARNP - Advanced Registered Nurse PractitionerCN - Certified NutritionistDC - Doctor of ChiropracticDDS - Doctor of Dental Surgery/ScienceDERM - DermatologistDMD - Doctor of Dental MedicineDO - Doctor of Osteopathic MedicineDPM - Doctor of Podiatric MedicineDPT - Doctor of Physical TherapyDVM - Doctor of Veterinary MedicineENT - Ear, Nose, and ThroatFDN - Functional Diagnostic NutritionistFMP - Functional Medicine PractitionerFNTP - Functional Nutritional Therapy PractitionersHC - Health CoachLAC - Licensed AcupuncturistLPC - Licensed Professional CounselorLMT - Licensed Massage TherapistMD - Doctor of MedicineNC - Nutrition CounselorND - Naturopathic DoctorNP - Nurse Practitioner/ Family Nurse PractitionerOBGYN - Obstetrician-GynecologistOD - Doctor of OptometryOT - Occupational TherapistPA - Physician AssistantPhD or PsyD - Psychologist/PsychiatristPT - Physical TherapistPT - Personal TrainerRDN - Registered Dietitian NutritionistRN - Registered NurseRPH - Registered PharmacistOther (specify below) Specify Type of Credential(Required) How did you hear about Systemic Formulas?(Required) Google, Bing, or Yahoo Facebook or Instagram YouTube LinkedIn Webinar or Online Summit Tradeshow Patient Another Practitioner or group Other Who is the practitioner or group that referred you?(Required) Upload License or Certification(Required) Drop files here or Select files Max. file size: 50 MB. Upload Resale Certificate or Tax Exemption DocumentMax. file size: 50 MB. Acknowledgement of Resale Policy(Required)ACCEPTANCE OF TERMS The following Terms of Service Agreement (the “TOS”) is a legally binding agreement that shall govern the relationship with our users and others which may interact or interface with systemicformulas.com, also known as Systemic Formulas, located at 626 W. Stockman Way, Ogden, Utah 84401 and our subsidiaries and affiliates, in association with the use of the Systemic Formulas website, which includes systemicformulas.com, (the “Site”) and its Services, which shall be defined below. QUALIFICATIONS NECESSARY FOR PURCHASING Systemic Formulas, Inc’s nutritional supplements must be purchased at the wholesale price by individuals identified by Systemic Formulas, Inc as authorized healthcare professionals. All healthcare professionals interested in purchasing Systemic Formulas products must provide a copy of their practitioner’s state license, professional degree, or professional certificate. Accepted degrees include, but are not limited to: M.D., D.O., N.D., D.C., D.D.S., L.M.T., L.Ac, R.D., M.S., N.P., C.N., C.C.N., C.N.S., and R.Ph. A practitioner meeting these qualifications listed above will be considered an authorized healthcare professional and a qualified Systemic Formulas customer and therefore will be able to purchase Systemic Formulas products at wholesale pricing. The practitioner must also provide a tax ID number and resale certificate number demonstrating they are purchasing Systemic Formulas products for resale and not personal use. A practitioner's first order is subject to a minimum purchase amount requirement. SALES TAX Sales tax will be assessed on qualifying purchases. Valid resale certificates may be submitted to potentially exempt products from sales tax depending on the shipping location and the current state sales tax laws. If you have one or more state resale certificates, please work with our customer service team to submit those certificates for validation. SYSTEMIC FORMULAS DISPLAY RESTRICTIONS Products must be displayed and offered for sale through a dispensary in an authorized healthcare professional/qualified Systemic Formulas customer’s medical practice, or behind- the-counter at a pharmacy or health food store to patients of an authorized healthcare professional. SYSTEMIC FORMULAS RESELL RESTRICTIONS Systemic Formulas prohibits resell of its nutritional supplement products to any individual other than those persons who are considered an authorized healthcare professional/qualified Systemic Formulas customer’s patient/client or for their personal use. PROHIBITED SYSTEMIC FORMULAS INTERNET SALES Products must not be offered for sale or sold on the Internet, except through an authorized healthcare professional/qualified Systemic Formulas customer website that is password-protected with a unique, non-automatic password intended to limit access solely to the authorized healthcare professional/qualified Systemic Formulas customer’s patients/clients. Any claims or suggestions of Systemic Formulas product discounting are prohibited. Systemic Formulas products and prices, including references to discounts of its products are not to be allowed or displayed in any Internet advertising, including websites, banner and pop-up advertisements, and search engines, such as Google, Yahoo!, AOL, MSN, e-bay and Lycos. Systemic Formulas strongly believes that the healthcare professional plays a critical role in educating and maintaining relationships with their patients/clients that maximize the wellness benefits to their patients/clients (while taking nutritional supplements). Unfortunately, web retailers can successfully eliminate the healthcare professional from this vital role by selling directly to the patients/clients. In addition to selling directly to patients/clients, these web retailers do not provide guidelines for proper use of professional supplements. This can, in some cases, be detrimental to the patient/client. Instead, they simply list the item and the price (often discounted), as their goal is to just make money. Protecting the patient and healthcare professional relationship ensures that patient/client will experience the positive health outcomes they expect from the Systemic Formulas product line and your practice benefits accordingly. By signing the attached agreement, you will be helping Systemic Formulas prevent future web retailers from selling Systemic Formulas products online. We appreciate your support and look forward to working with you in the future to achieve the best nutritional results for your patients/clients. I have read, understand, and accept the Systemic Formulas Resale Policy. Choose Your Password(Required)Password must include: - 8 or more characters - at least one uppercase letter - at least one lowercase letter - at least one number - at least one special character Confirm Your Password(Required) Signature(Required) ![Clear Signature](data:image/png;base64,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) Marketing Consent(Required) By requesting an account, I agree to receive marketing communications. 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