Distributors | Life Support Health Products

Why Become a Distributor?

By becoming a distributor of Life Support Health Products, you receive inventory at wholesale directly from us to implement in to your practice. Fill out the form today and one of our team members will contact you shortly to set up your account.

Download and fill out the attached form and upload with your registration along with your specialist practice license. Hit submit. If you are not able to upload your documents at this time, you can fax them to 913-214-1945.
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Become a Distributor

If you are interested in becoming a LifeSupport distributor, please complete out the form below, and a member of our team will contact you with details.

Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Username*
Email*
Upload Sales Tax Form
Max. file size: 512 MB.
Upload License
Max. file size: 512 MB.
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Why Become a Distributor?

Become a Distributor

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