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International Distributor/Dealer Application

ZRT Laboratory is interested in developing partners in foreign markets to better meet the needs of health care providers and consumers around the world.

We are interested in working with health care providers/entrepreneurs who are interested in growing their market by using innovative, advanced testing services.

If this sounds interesting to you, then don't let this opportunity pass by; please complete as much of this application/survey as possible and click submit below when done. (*) = required field

Name (*)
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Company (*)
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Address (*)
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Address2
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City (*)
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State (*)
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Zip (*)
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Country (*)
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Email (*)
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Phone (*)
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Current number of active customers on file:
Health Care Providers
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Hospitals
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Direct To Consumer
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Annual Gross Revenue
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Number of years in business (*)
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Business web site
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Do you currently market or sell any medical products or tests through your business?

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If yes please specify
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Do you have experience with lab diagnostic testing?

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If yes please explain
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Do you have experience in marketing to consumers?

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How do you market your business? (please select all that apply below)





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Other (please explain)
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Into which countries do you actively market, sell, ship, distribute, and attend conferences? (*)
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Do you have a facility or office to store and/or assemble test kits?

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Do you have reliable shipping and receiving capabilities at your offices or place of business? Please check which might apply?




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Other (please specify)
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ZRT Laboratory supports innovative, enterprising business models; please tell use about your business model and how we can best support you:
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