A re-usable and self-adhering prosthetic nipple - so you're whole again
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Doctor Inquiries



It's easy to become a dealer or reseller of ReForma products. You must meet the following requirements:

  • You must be a licensed doctor.
  • You must have a valid sales tax reseller certificate if you are located in Florida.
  • If your medical practice meets the above requirements, complete the following steps to apply for your medical discount account:

    Step 1: Create a MyReforma user account

    You must have a MyReforma basic user account. If you don't already have one, click on the "Login or Create an Account" button above and enter the information required to create an account. Please fill in all information as we will not consider accounts with incomplete or inaccurate information.

    Step 2: Request an Upgrade to Wholesale

    If you are not already logged into your account, please login now. After you have logged in, click on "My Account" above and then click on the section "Request Account Upgrade." Select "Wholesale Account" when asked for the account type. You must include your medical license number.

    Step 3: Fax us a copy of your Resale Tax Certificate (Florida businesses only)

    If your business is located in Florida, fax us a copy of your resale tax certificate to 561-655-3951. The business name on your certificate must match the business name on your MyReforma account.

    Step 4: Approval

    After we receive your upgrade request and copy of your Resale Tax Certificate (if required), we will consider your application and notify you by email after we have approved your request. The next time you login to your account, the medical discount pricing will be available to you.