New Partner Inquiry – Foothills Professional Pharmacy

New Partner Inquiry – Foothills Professional Pharmacy

Foothills is licensed in all 50 states and specializes in custom compounding solutions with fast turnaround times, exceptional service, and no hidden fees. We'd love to learn more about your business and how we can support your patients.
1️⃣ Let’s Start With You
Company Name:*
Website (if available):
Primary Contact Name:*
Title/Role:*
Email:*
Phone:*
Please enter a valid phone number.
Business Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2️⃣ What Best Describes Your Business?
Select all that apply:*

Telemedicine PlatformMedical ClinicWeight Loss BrandMen’s Health or Women’s Health BrandDermatology / AestheticsSupplement or Wellness BrandOther
3️⃣ What Are You Interested In?
What services or products are you looking to offer through our pharmacy?
Key therapeutic areas (e.g., TRT, GLP-1s, dermatology, etc.):*
Common prescriptions you’ll send our way:*
Expected script volume (daily or weekly estimate):*
4️⃣ Your Coverage & Licensing
What states do you currently serve?*
Do you require multi-state prescription fulfillment?*
5️⃣ Tech & Integration
Can your platform integrate with LifeFile or another API system?*

YesNoNot Sure
6️⃣ Communication Preferences
Preferred contact methods:*

SlackEmailPhone
Who should we contact for:
Prescription clarifications:*
Patient support issues:*
Billing / Invoices:*
7️⃣ Shipping & Fulfillment
What shipping speeds do you need?*

GroundTwo-DayNext-Day
8️⃣ White Label & Branding Needs
Do you require customized materials? Select any that apply:*

Prescription labels with your brandingPatient literature sheetsCustom bottlesCustom mailersOther
✅ Why Foothills?
• No Extra Fees – No implementation, admin, or clinical fees

• Fast Turnarounds – Efficient fulfillment and nationwide shipping

• Hands-On Support – A dedicated account manager & responsive customer service
Next Steps

Once you complete this form, our team will follow up to schedule a brief onboarding call and begin the process.
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