1stRX Partner Application

Tell us about yourself and how you plan to grow with 1stRX. We review every application personally.

✅ Application Submitted!

Thank you for applying to the 1stRX Partner Program. We'll review your application and be in touch within 2–3 business days.

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Full Name *

Email Address *

Phone Number

Location (City, State) *

Business Name (if applicable)

Which best describes you? *

Content Creator / Influencer Coach / Consultant Clinic / Medical Provider Business Owner Other

Audience Size (approximate) *

Under 1,000 1,000 – 10,000 10,000 – 50,000 50,000 – 100,000 100,000+

Describe your audience (who do you serve?) *

Have you promoted health, wellness, or telehealth products before?

Yes No

How will you primarily reach people? *

Online (social media, email, website) In Person (events, gym, clinic, word of mouth) Both Online & In Person

Online channels (select all that apply)

Instagram TikTok YouTube Facebook Email List Website / Blog

In-person methods (select all that apply)

Gym / Fitness Studio Clinic / Medical Office Events / Conferences Word of Mouth / Personal Network Community Groups Other

Describe how you'll promote 1stRX in person *

How do you plan to promote 1stRX? *

Do you agree to follow 1stRX marketing and compliance guidelines? *

Yes No

Why do you want to partner with 1stRX? *

What are your goals with this partnership? (select all that apply)

Side income Primary income stream Add value to existing audience Long-term partnership

How many customers do you believe you could refer in your first 90 days?

Would you be open to a short onboarding or strategy call if accepted?

Yes No

Who referred you to the 1stRX Partner Program?

We review every application and respond within 2–3 business days.