Thank you for your interest in RxMobility™
To be considered for an RxMobility® distributor or retail account, please click below and download the application form. EMAIL the completed form to with the subject line "Retailer Application".
As we receive a large amount of requests for new accounts, we work to respond to all requests in a timely manner. Please allow approximately 3-5 business days for an application to be processed.
If you have not received a response within this time frame, please do not hesitate to contact us at (678) 977 - 9259.