Apply to carry the protocol

Approved practices receive a complimentary Pilot Kit with ten professional doses. Two minutes to apply.

Full name *

Your role *

Work email *

Use your practice email if you have one.

Mobile *

Text me my protocol card and onboarding updates.

Practice name *

Practice type *

Practice website or Instagram *

However patients find you.

Street address *

Suite / Unit

City *

State *

Zip *

Include your suite number — it's the most common reason a kit gets returned.

Lip filler appointments per month *

Which injector will run the protocol?

Leave blank if that's you.

First professional dose *

Pick a day you have lip appointments booked. Your kit will arrive before then.

I confirm I am a licensed provider or authorised representative of this practice, and I agree to the Partner Terms.

We review every application by hand. You'll hear from us within one business day.

Application received