Distributor Signup

If you would like to become a ReleaseSCE Distributor, please complete the below form as follows:

- If you are a VAT Registered Business or have a Medical Practice Number, please select the appropriate options from the Business Type field and complete the required details.

- If you are neither of the above and would like to still become a Distributor, please complete the form below and select Other from the Business Type Field. You will be required to upload a Motivation Letter for consideration.