Partner Information

If you are a chiropractor, ergonomist or other related Medical Markets professional and would like to become a reseller of Humanscale’s products, please download the below forms and follow the instructions for submitting them to Humanscale.

• Form #1 — Business Associate Agreement (United States and Canada)
  This Agreement is between Humanscale and any Medical Markets Practitioner that is interested in entering into an agreement to be a re-seller of the Humanscale products. Please fill in all the pertinent information and sign the agreement on page 4. Please return to your Humanscale representative for a signature from Humanscale. It will be kept on file at Humanscale.
• Form #2 — Humanscale Corporation Account Registration (United States and Canada)
  This form allows Humanscale to set up an account in our ordering system and create a code specifically for the individual practitioner. This will enable the practitioner to enter their individual affiliate code on our online ordering system and accurately place orders with the proper affiliate discount. Please return this form to your Humanscale representative for processing. Your Humanscale representative will contact you when your affiliate code has been activated.
• Form #3 — HIPAA Compliance Form (United States only)
  This form is for the Medical Market Practitioner to use in alerting patients to the required disclosure of some personal information in the transaction between the practitioner and Humanscale. This form should be presented to the patient at the time of ordering so that they completely understand the information that will be disclosed to Humanscale. The Medical Market Practitioner should keep this on file in their office and should obtain authorization for every order placed with Humanscale.
• Form #4 — HIPAA Compliance Form (Canada only)
  This form is for the Medical Market Practitioner to use in alerting patients to the required disclosure of some personal information in the transaction between the practitioner and Humanscale. This form should be presented to the patient at the time of ordering so that they completely understand the information that will be disclosed to Humanscale. The Medical Market Practitioner should keep this on file in their office and should obtain authorization for every order placed with Humanscale.