doTERRA Customer Information Form
Please fill out the below information to begin processing your dōTERRA wholesale customer account (no monthly minimums or purchase requirements). Should you have questions at any point please don't hesitate to reach out to me personally: 714-200-7006 (call or text ok) or
Natural Health & Wellness by Reija - AADP Certified Essential Oil & Health Coach
First & Last Name
Full Address: City, State, & Zip Code
Shipping Address (only if different than primary address)
Primary Phone Number
Primary E-Mail Address
Full Birth date MM/DD/YYYY
Where do you start?
To view the details of these kits please visit
Family Essentials Kit $150 ($36 savings)
Aroma Touch Diffused Kit $150 ($32 savings)
Home Essentials Kit $275 ($86 savings)
Cleanse & Restore Kit $245 ($81 savings)
Emotional Aromatherapy Diffused $195 ($69 savings)
Natural Solutions Kit $550 ($230 savings + $100 back in product credit)
Every Oil Kit $1825 ($630 savings + $200 back in product credit
Diamond Kit $2650 ($866 savings + $400 in product credit
Custom Kit $35 fee + items you selected at wholesale cost
Master Your Metabolism Event $277 + FREE bottle of Frankincense ($93 value!)
If you chose the $35 custom kit OR if you want to add additional items to your kit please detail them here:
Payment Info: Card Number
Payment Info: Card Expiration Date: MM/YYYY
Payment Info: Card Security Code (3digit)
Full Billing Address (if different than shipping address)
Are you interested in learning more about how you can share the dōTERRA lifestyle with others for free products or cash?
Yes- I know some people who would be interested, lets plan something!
Possibly- Can you text or e mail me more info?
Not right now- Thanks though!
Just Some "Compliance Jargon"...
By checking the box below you are consenting to becoming a dōTERRA customer, and understand your information will be sent for processing. To read all of the terms and conditions please visit this website:
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