Partner Application

Request access to the partner portal

A short application so we know who we're speaking with. We review every submission personally — typically within one business day. Approved practices receive a portal invitation and a partner agreement to review.

Who you are

Step 1 of 3

The name and contact details that will appear on your partner agreement.

Required

Required

Your portal invitation and agreement are sent here.

Enter a valid email address

Required

Required

Your practice

Step 2 of 3

How your practice appears on the agreement and in our records.

Required

The fastest way for us to verify your practice.

Required

Required

Leave blank if your role does not carry a National Provider Identifier.

What you're looking for

Last step

So the right person follows up with the right information.

Which biologics interest your practice?

Select at least one

Required

We couldn't submit that

Something went wrong on our end — your details are still on screen, so nothing is lost. Try once more, or reach us directly and we'll take your application by phone or email.

info@puremsc.com Admin & Support 928-928-0223

Application received

Thank you. We review every application personally and will be in touch within one business day.

✓  Verified against the federal NPI registry

Your National Provider Identifier checked out, so you don't have to wait on us to confirm anything. The partner agreement is on its way to your inbox now — review and sign it whenever suits you.

Prefer to talk first? That's completely fine. Leave it unsigned and we'll walk through it together on the call — though signing beforehand means we can be far more open about protocols and pricing when we speak.

Choose how you'd like to go forward

Recommended

Sign the agreement — opens your portal

Signing unlocks Level 1 access: protocols, handling and storage, Certificates of Analysis, patient materials, and ordering. It also means your kickoff call can cover everything openly, including pricing, instead of staying general.

Review & sign the partner agreement

Opens in a new tab. You'll confirm your name and email once — that's the document's own signer verification. Then book your 45-minute kickoff: choose a time

Talk first

Perfectly reasonable. A 15-minute discovery call — what your practice treats, which biologics may fit, how the portal works. We'll keep specifics general until the agreement is in place.

Book a 15-minute discovery call

Every field writes to a canonical contact field. Native GHL fields are preferred over custom duplicates, because natives are populated by every entry path — a custom duplicate always loses. These same codes become the merge tokens on the partner agreement.

QuestionContact fieldTypeAgreement token
First namefirst_nameNative{{contact.first_name}}
Last namelast_nameNative{{contact.last_name}}
Work emailemailNative{{contact.email}}
Direct phonephoneNative{{contact.phone}}
Practice namecompany_nameNative{{contact.company_name}}
Your rolerole__titleCustom{{contact.role__title}}
CitycityNative{{contact.city}}
StatestateNative{{contact.state}}
National Provider Identifiernpi_national_provider_identifierCustom{{contact.npi_...}}
Practice websitewebsiteCreate
Biologics of interestwhat_is_your_practice_looking_forCustom
Current supplier statuscurrent_statusCreate
— on submit —provider_nda_status = appliedCustom

The fix: the submission is an upsert keyed on email. An existing contact is updated in place; a new one is created with email and phone present from the first touch. That is what ends the orphan-duplicate problem — the current form writes several answers to company scope instead of the contact, which is why agreement tokens rendered blank.

Naming rule: biologics are written out in full everywhere a provider can see them — Natural Killer-derived Exosomes, Natural Killer Cells, Mesenchymal Stem Cell-derived Exosomes, Live (Non-Frozen) Mesenchymal Stem Cells. No abbreviations on any patient- or provider-facing surface.