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New Client On-boarding
Business Name
*
Type of Business
*
Type of Business
A
Independent Pharmacy
B
E-commerce Brand
C
Online Reseller
D
Clinic / Eye/ Dental Office
E
Spa / Rehab
F
Dispensary
G
Cannabis Grower
H
Other (with option to write in)
Type of Business (Other)
Years in Operation
*
Tax ID/EIN
*
Contact Person
*
Phone Number
*
Email
*
Pick up Address
*
Access Instructions
*
Services Interested in?
*
Services Interested in?
Fulfillment Services
Pharma Reverse/Waste Pickup
Last-Mile Delivery
Inventory Management
Custom Logistics
Brief Description of Products/Waste
*
Average Monthly Units
*
Preferred Pick Up Dates
*
Preferred Pick Up Dates
Monday
Tuesday
Wednesday
Thursday
Friday
Licenses/Certification
Licenses/Certification
DEA License
HIPAA Compliance
Hazmat Certification
State Board of Pharmacy License
Cannabis State License
Licenses, Certificates, Documents (Optional)
Click to choose a file or drag here
Size limit: 10 MB
By submitting this form, you certify that all information provided is accurate and complete. RhythmNRoutes will maintain confidentiality of all business information in accordance with our privacy policy.
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