Pharmaceutical Product -Marketing Inquiry

Thank you for your interest in inquiring about marketing a pharmaceutical or medical product at Bodhi Medical Care, LLC- Apple Pediatrics. Please fill out and submit your request below. We look forward to receiving your information and exploring the possibility of setting up a meeting with you.

First name (*) :

Last name (*) :

Title (*) :

Company you represent (*) :

Website of the company (*) :

Your Email (*) :

Your phone number (*) :

Please summarize the main reason of requesting to promote your company / product with us:

Please select what best characterizes the main purpose of your interest to visit us

Please list your professional background and years of experience in your field (*) :

Please list Please list up to 3 most important facts why you think you product is better than other similar products currently on the market :




Please list an approximate price or cost of your product a customer (patient) would have to pay should he/she needed to pay cash out of pocket for your product at a full price per month – in USD(*) :

Upload the product or company information (Max size 5MB) :

I am submitting this inquiry with the understanding that I accept full responsibility for being truthful about all information provided as well as the understanding that this form is no guarantee of an invitation for a business meeting or other business related activity.
Should we reach a decision to contact you our general response time is 3-5 business days.

Please sign your request (*) :

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