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Supplier
Application

Want to apply another way? Download our Supplier Application as a PDF or Word document.

Supplier Application

Yankee Alliance encourages all potential suppliers to apply for consideration. Please understand that submitting an application does not ensure that your company will be automatically qualified. If your application is accepted your company will be deemed eligible to compete.

The application review process will take 2-4 weeks. If Yankee Alliance decides to pursue a contract with your company, please expect the process to take up to 90 days to finalize a contract award. The process could be longer depending on your responsiveness and the complexity of the product line.

Thank you for your patience and understanding. We look forward to reviewing your application and the potential opportunity to work together to bring value to Yankee Alliance members.

Company Information

Primary Contact

Product/Service

Differentiation

Value + Benefits

Why should Yankee Alliance partner with your company?

Expectations

What is your annual sales volume/Market Share?

Publicly owned or Privately owned?

If Privately owned, do any physicians (or their immediate family members) have ownership stake in the company?

If yes, please provide a separate report detailing the physician owners, including practicing location and medical license # (if applicable).

Is the company classified as a HUB (small, minority, woman owned, Veteran owned) supplier?

Has the company been excluded from participation in Medicare, Medicaid, or any state reimbursement programs?

Does your company have approval from all federal, state and local governments in the US?

Brief company overview

What geography does your company serve?

Are products available direct, through distributors or both?

If so, through what channels?

What Classes of Trade does your
company serve?

Please provide ordering procedures.

Where are your company’s products
produced?

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Have Questions?

If there are any questions regarding your application, please contact Todd Senard at .

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