Affiliate Program

Affiliate Onboarding

Complete the intake form below to begin your application and onboarding as a NEUAGE affiliate partner.

Affiliate Partner Program

Design Intake &
Account Setup

Complete the form below so our web design team can build and configure your affiliate landing page. All information submitted here routes directly to the team for WordPress account creation.

Submitted To
Web Design Team
Platform
WordPress + Refersion
Routing
Formsite → Salesforce

Before You Begin

This intake form collects everything our design team needs to create your affiliate account page on the NEUAGE Health + Wellness website. Once submitted, your information will be routed to the web design team and entered into Salesforce for tracking.

Have the following ready: your business or personal branding details, preferred contact information, any logo files or creative assets, and your Refersion affiliate account email if you have one.

1
Complete Form Fill out all required fields below
2
Design Review Team reviews within 2–3 business days
3
Page Creation WordPress account & page go live
4
Confirmation You'll receive login credentials via email

Affiliate Design Intake Form

NEUAGE Health + Wellness — Internal Onboarding

Secure Form