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US Dealer Application

We appreciate your interest in working with Bodypoint. From shoulders to feet, our products carry a limited lifetime warranty and are tested to RESNA/ANSI, EN and ISO standards for performance and safety. Access detailed clinical, technical and sales support via our Web site, email and our customer service center, 800 547-5716, staffed from 7:00-4:30 Pacific time. We are always happy to help you select, size and mount our products.

We look forward to our partnership!
1. Are you looking to sell Bodypoint products:
3. Please choose one option.
No problem! After your application has been processed, one of our Customer Service representatives will contact you to help you complete your initial order.
3. Please upload your Bodypoint purchase order, using the "Browse" button. We will process it upon approval of your dealer application.
This question requires a valid number format.
This question requires a valid date format of MM/DD/YYYY.
calendar
11. Preferred payment method *This question is required.
12. Contact for credit card information:
This question requires a valid number format.
12. Please note the following Terms and Conditions, and signify your acceptance  thereof by completing the credit application below. 
  • The person or business signing below ("Applicant") hereby makes this application for credit to Bodypoint, Inc. and or any of its subsidiaries or affiliates now owned or hereafter acquired ("Creditor").
  • In making this application, Applicant agrees that all amounts payable on or before the due date as shown on each invoice will be paid, and if not paid on or before said date, are then in default.
  • Should credit availability be granted by Creditor, all decisions with respect to the extension or continuation of credit shall be at the sole discretion of Creditor. Creditor may terminate any credit availability within its sole discretion.
  • Applicant understands that Creditor is relying on the truth and accuracy of the information provided in this application for credit as well as any other information provided to Creditor including financial statements (in aggregate, the "Credit Application"). Creditor would not extend credit to Applicant without full and accurate information provided for in the Credit Application.
  • Applicant will provide any other information from time to time upon request of Creditor including an updated Application, financial statements, and information regarding secured financing.
  • Applicant authorizes Creditor to conduct any credit investigation deemed necessary of Applicant, including, but not limited to personal credit information about Guarantors, General Partners, Proprietors, and Individual Applicants.
  • Applicant hereby explicitly authorizes Trade References cited above to release credit information.
  • The undersigned further declares that he/she is duly authorized to sign the Credit Application on behalf of Applicant.
  • In any event, Creditor reserves a security interest in all goods sold to applicant until amounts owing are paid in full. Any invoice not paid by its due date is subject to an interest charge of 1.5% per month (18% per annum), finance charge, and will be applied to any unpaid or outstanding balance. This interest charge is cumulative for any month(s) and/or portion thereof where there remains an outstanding balance.
  • Should litigation or collection action be necessary or result due to default of payment of the above balance (plus any interest due), all legal fees, court expenses, and any and all other reasonable expenses incurred by Bodypoint, Inc. or their authorized agent to enforce payment of the balance due on this account, will be paid by the party whose signature appears hereon.
  • Applicant agrees to pay a $50.00 service charge on any returned check.
  • In the event of default, Applicant further agrees to pay all costs of collection, including all reasonable attorneys' fees, plus court costs and/or collection agency fees together with interest thereon at the maximum amount allowed by law to Creditor or its assignee.
  • Applicant agrees that Creditor may rely on facsimile copies of this Credit Application as equally binding as if executed in original. By executing the Credit Application below, Applicant acknowledges and agrees with the terms and conditions stated above.
CREDIT APPLICATION

Please list three trade references below, preferably in the medical equipment or health care sectors. 
Space Cell Supplier nameAccount numberPhone numberRecent high credit
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12. Please sign and enter your name and title to accept the Account Agreement as outlined above on behalf of your organization. *This question is required.
Clear
Signature of
12. A/P contact (for Bodypoint invoices)
This question requires a valid email address.
13. Is your shipping address the same as billing? *This question is required.
14. Shipping address
 
This question requires a valid email address.
14. President, CEO, owner or other duly authorized representative
This question requires a valid email address.
15. Purchasing contact
This question requires a valid email address.
16. Please list any credentialed mobility professionals in your organization who should receive our clinical and product updates.
Name Email Credential(s)
ATP OT PT RET RRTS SMS
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17. Please upload a current, complete and signed resale certificate or tax exemption form for each of your ship-to states, using the "Browse" button below. Make sure file names have a .pdf at the end before trying to upload them.

If you have multiple locations, please contact us using the information below.

If needed, you may email certificates to sales@bodypoint.com, or fax to BP Customer Service at (206) 405-4556. If you have more than five States, you may complete a Multijurisdictional Resale Certificate for cooperating states.
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