Retailer Contact Form
Are you an Ontario Retail Store? Contact us to request an in store visit, more information on our products or just to make some connections. Please note: We will do our best to accommodate in store requests but location will be a factor. Furthermore, a manager or store owner must be present in order for us to leave samples and we need to document your Health Canada License number. 

**If you are not a licensed Ontario retailer and fill out this retailer contact form we will not respond to your inquiry. For consumer or other inquiries please see our general contact page or email info@mariwell.ca. 
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Name of Manager or Store Owner: *
Valid store, manager or owner email address:  *
Best phone number to reach you at: *
Store name:  *
City where the retail store is located:  *
I would like to: *
Required
Health Canada License Number (if possible, it makes our job easier!): 
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