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Retailer Inquiry

Please fill out the form below and we will be in contact within 3 business days.

Fields marked with (*) are required

Your Name: *
Your Position: *
Name of Business: *
Address 1: *
Address 2:
City: *
State: *
Zip: *
Mailing Address Same as Business Address:
Mailing Address 1: *
Mailing Address 2:
City: *
State: *
Zip: *
Phone Number: * () -
Email: *
Fax Number: () -
Website:
Which of these best describes your business?*
Other:
Which best describes the location of your business?*
Other:
Number of years business has been open: *
Number of Locations:
Do you currently sell skin care products?
Do you currently sell natural skin care?*
Which categories of Dr.Hauschka products are you interested in offering your customers?
Face Care
Body Care
Decorative Cosmetics
Bath & Shower
Hair Care
All of the above
Are you interested in using Dr.Hauschka Skin Care in spa services?*
Which spa services are you currently offering, if any?
Facials
Manicures
Pedicures
Massage
Other - please specify
Other:
Please list the skin care brands you currently retail and provide us with any other details about your business and interest in DHSC that you would like to share:
If you have any photos of your business, we would love to see them. Please upload up to three of them below. Maximum file size is 1MB.
Uploaded Image 1:
Uploaded Image 2:
Uploaded Image 3:
 
 
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