Affiliate Registration Form

Our Affiliate Program is designed for independent or private practices only who specialize in pelvic muscle rehabilitation and would like the benefit of a world-class distribution channel; without the expense or space to maintain one.  CMT, a business leader specializing in pelvic muscle rehab products and services will fill your patients orders so there is no guess-work from you!

What are the benefits?  Well, in addition to being the fulfillment agent for the products you typically refer to your patients, CMT will provide the facility with a referral fee based on the products sold through your unique landing page which we will create for you and you will embed onto your website.     To get started, simply fill out the form below.

Affiliate Registration

Want to become a CMT affiliate? It is easy, and we just need some information to get you going. Please fill out the below form and you will be notified of your affiliation approval via email. Thanks for being a loyal CMT partner!

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  • Check off as many of the products below that you would like featured on your affiliate page. If a product is not listed here, please add it in the section below.
  • Please enter it as you'd like it to appear on your personal landing page.
  • Please add a logo for your landing page. No larger than 200 pixels tall, JPG, PNG and GIF files only, max of 2MB.
    Accepted file types: jpg, gif, png, Max. file size: 50 MB.
  • Please add your PayPal email address. You must have a PayPal account to receive payment.
  • This field is for validation purposes and should be left unchanged.