California Baby
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California Baby Contact Form

Name *
First

Last
Email *
Phone *

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Extension (if applicable)
Address *
Street Address
 
Address Line 2
 
City

State
 
Zip Code
Mainland (US Only)


Country

Website (if applicable):

Practioner Information

Name of Practitioners: *
Name of practice or hospital: *
Type of practice and/or specialty: *
Total # practitioners at facility: *
Estimated # of patients seen monthly: *

Product Information

Which type of products are you interested in? Please complete conditions treated.

Product Type:
Shampoo & Bodywashes: sulfate free, plant-based cleansers
Medical Condition (ie. eczema, dermatitis, etc.)
Creams/Lotions: naturally based, deep hydration
Medical Condition (ie. eczema, dermatitis, rash, etc.)
Broad Spectrum Sunscreens: mineral-based, non-chemical actives
Medical Condition (ie. eczema, dermatitis, etc.)
Please check one or all: *
 I am interested in referring California Baby products to our patients 
 I am interested in selling California Baby products 
 I am interested in referring to a local store or pharmacy 
How did you learn about California Baby products? *
 Patient Referral 
 Physician Referral 
 Advertising  
 Google Search 
If other, please list:

Please Read Carefully:

1. Requests will be fulfilled based on inventory. Due to the high volume of requests we receive, not all forms submitted will be filled.
2. All form submissions will go through a screening process; unapproved requests will not be filled.
3. We do not offer any monetary support or sponsorship.
4. You must be available to accept UPS delivery of samples. We do not ship to PO boxes.
5. California Baby will determine the number and type of product provided.
6. Applicant agrees to distribute samples as provided by California Baby. We cannot be held liable for products opened and redistributed outside of factory conditions.
7. California Baby is under no obligation under this agreement.


By submitting this form, I understand and agree to the terms above.


California Baby® products are proudly made in the U.S.A. in our FDA registered and certified organic solar powered facility.
All products are allergy tested and free of peanuts, soy, or dairy. No animal testing.