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.

Something went wrong submitting your application. Please try again or email josh@immortalwellness.com directly.

Full Name *

Email Address *

Phone Number

Location (City, State) *

Business Name (if applicable)

Website (if applicable)

Which best describes you? *

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

Primary Platform(s) (select all that apply)

Instagram TikTok YouTube Facebook Email List Website / Blog 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

If yes, which products or services have you promoted?

What has worked best for you when promoting products/services?

How do you plan to promote 1stRX? *

Which channels will you primarily use?

Organic social content Email marketing Community / group Direct client referrals Other

How often do you typically create content or engage your audience?

Daily Weekly Occasionally

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

Yes No

Are you comfortable promoting physician-guided telehealth services responsibly and accurately? *

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?

Are you interested in building a team of partners (Tier 2 opportunity)?

Yes No

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

Yes No

Anything else you'd like us to know?

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