View CartMy Account / Order StatusHelp
    Aromatherapy Glossary of Terms What is Aromatherapy? FDA Rules: Cosmetic or Drug?
Who Is Mother Anita?
Professionals
Wholesalers
Account Signup
Mother Anita’s® Fine Body Balms & Vibrational Healing Spritzs
Each balm and spritz connects you with nature & yourself, your breath, your beauty. Enjoy our joyful, intentional, loving, Aromatherapy products!
THE BALMS
Balance ... Center yourself with this fine body balm rich in lanolin & vitamin E. Therapeutic essential oils of lavender, rose geranium, vetiver and lemongrass do the work.
Comfort... Offer aches, pains, owies, scars, bug bites, burns, sunburns and peeling cracked hands & feet to the Gods of the past...
THE SPRITZS
Essential Rose: receive clarity, purity, universal love
Essential Chamomile: experience more peacefulness, less worry, fear, anger, anxiety
Smokeless Sage® Smudge: clear, center, & reconnect with your intuition
Ancient Beings®: lighten, find your mission, live it – great for meditation Spray gently over your head, breathe deeply, & welcome nature’s gifts.

Join our mailing list!






HACKER SAFE certified sites prevent over 99% of hacker crime.
You are here: Home > Account Signup > Professional Request Form - email

PROFESSIONAL ACCOUNT REQUEST

Please complete the information below and allow 1 business day for your account to become active. Your information will not be sold to others, nor will it be used by anyone other than Hummingbird Therapeutics. The information you share with us helps us to assure that qualified professionals are receiving discounts, and to enhance and simplify your shopping experiences at Mother Anita's. In a hurry? Check out our quantity discounts online available to all buyers.
For more privacy information please go to privacy tab at the bottom of the home page.


* items marked with an asterisk must be completed prior to submission.

     * Email Address:
* Desired Password:



Personal Information

                          Title:
              * First Name:
              * Last Name:

* Business Name/DBA:

                 * Job Title:

       * Mailing Address:

                       * City:

                     * State:

               * Zip Code:

      * Daytime Phone:

               Cell Phone:

            Home Phone:

   * Best Time to Call:

              * AM or PM:



Professional Information

To be considered for professional pricing, please complete the following fields. If you do not complete all fields you will not be considered for professional pricing. We may contact you if needed prior to setting up your account.
All Medical, Massage, Alternative Healing, and Personal Care modalities will be considered for professional pricing


* Professional Work Performed:

Where are you licensed?
                                    * City:
                                  * State:


              License Number:
If you have not provided licensing information, please explain:


* What training institutions have you attended/are you attending?:


          Are you currently a student?:

                       * Years Experience:


Is it OK to solicit you by postal mail:
        Is it OK to solicit you by email:

                                Your Website:




Hummingbird Therapeutics
PO Box 730
Merrimack, NH 03054
 About Us
 Become an Affiliate
 Privacy Policy
 Send Us Feedback