Create Account | Consolidated Wellness Solutions, LLC |

Instructions

All of the fields marked with an asterisk are required. Once you submit the form, one of our employees will verify the information provided and then activate your account if you qualify. Once your account is approved by us, you will receive an email letting you know that you can log into the web site. Please make sure that you provide a valid email address so that you receive the notification! You will have to check this email address to finish creating your account.

Please note! If you do not provide us with a corporate mailing address and/or a corporate email address your account will not be approved without additional information..

Your Info

Are you interested in our products for personal or professional use? *

Title *

First Name *

Middle Initial

Last Name *

Business Name *

Address *

Address 2

City *

State *

Postal Code *

Phone Number *

Email Address (this will be your login ID) *

Confirm Email Address *

Password *

Confirm Password *

Please upload a copy of a valid business license or certification. This is not mandatory at this time but will expedite your request.

Electro Dermal Screening

Do you currently own any ElectroDermal Screening (EDS) or BioFeedback equipment?

Yes

If so, what is the manufacturer of the system? (Discovery, ZYTO, BioMeridian, etc)

Have you been tested on an ElectroDermal Screening (EDS) system?

Yes

If you have been tested, who performed the test?

If you own a Discovery System from Consolidated Wellness Solutions, LLC, what is the hardware serial number of your device?
(This is found on a sticker on the bottom of the Discovery unit)

Products You're Interested In

Please select at least one

Consolidated Wellness Solutions, LLC

DesBio

Enzyme Research Products

Marco Pharma

Mediral International, Inc.

Note: we will never sell, lease, or share your information with anybody.

Remember! Once you submit this form, one of our employees will then verify the information. Make sure your email address is correct and that you will be able to receive mail at the address - you will not be able to activate your account otherwise.