We’re so excited to welcome you to the Regenesis Ambassador family!

Whether you help people look their best, feel more confident, or live healthier lives, this program is built for you.

Your Information

Full Name *

Company Name *

Phone *

Email *

Website / Instagram / Facebook (optional)

Your Business

Profession / Primary Service

How many employees or team members do you have (if applicable)?

On average, how many clients do you serve per week?

Your Goals & Vision

What are your current health and wellness goals (if any)?

Have you ever participated in a weight loss or body and health transformation program before?

Yes

No

If yes, what was your experience like?

What excites you most about partnering with Regenesis Health & Body?

What would make this a valuable partnership for you?

Program Involvement

How would you prefer to refer clients? Check all that apply.

I’d love printed cards & flyers

I prefer a QR code to share on social or in my shop

I’d like a custom referral link

I’m open to hosting pop-up events or cross-promotions

Other

Would you be interested in featuring Regenesis in your space (signage, displays, or co-events)?

Yes

No

Maybe

Anything Else You’d Like Us to Know?

Next Steps:

Once submitted, our Brand Manager will contact you with your ‘Ambassador Welcome’ information and resources to start earning credits right away!

📞 Questions? Call us at (760) 696-3388