DSS Sign-up

Doctors Supplement Store Online Signup

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Increased sales, reduced hassles
and Uncommonly Good Customer Service!

FREE, no-risk setup (U.S.-based healthcare professionals only)

Please email or call if you need assistance.

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Please send me a Master Supplements, Inc catalog with Master Supplements, U.S. Enzymes and Tomorrow’s Nutrition PRO product information

About Your Practice
Full Name:*

First NameLast Name
Degree/Credentials:*
E-mail:*
Your Practice Name and Address will be displayed on your online store and on patient order receipts.
Practice Name:
Name of the Practice Owner:
Practice Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Practice Phone Number*
Practice Phone Number
Practice Website:
Please use format: www.website.com
Why did you choose Doctors Supplement Store?
How did you hear about us?
Referral or Promo Code (if applicable)
Please provide an additional contact, such as an Office Manager, if applicable.
Contact Name

First NameLast Name
Position
Email:
Phone
View our Terms of Service. (Recommended)
Please Check:*

I received a copy of the Terms of Service and agree to them. The information provided in this application is complete and accurate to the best of my knowledge, and I'm authorized to submit it on behalf of my practice.

Orientation

The best way to learn about your dispensary and your Control Panel is to participate in a brief, live online orientation. Request a time that works for you and we'll do our best to accommodate that time.
Orientation Date

MonthDayYearHourMinutesAM/PM Option
I prefer not to have an orientation (not recommended)
Orientation Date
My Time Zone:
Customizing Your Store

NOTE: Options can be changed at any time by contacting us.
Website Address for Your New Store

Enter the word or phrase to use after www.DSSOrders.com for your store's web address:
Word or Phrase to Use:*
Example: www.DSSOrders.com/DrSmith
Notification Email Address

Enter the email address for notifying you when patients register and order.
Notification Email Address:*
Site-Wide Discount (optional)

You may optionally discount prices across-the-board on your site. This discount comes out of your earnings. You can estimate the impact by multiplying the discount by 4. For example, if you offer 10% off, you’ll be foregoing approximately 40% of your earnings.
Enter the maximum percent off retail price you want to offer*:
*Products with lower margins may be discounted less than the amount you select.
IMPORTANT: If you choose to direct all of your earnings towards a site wide discount (25% off retail), the Rewards program will be disabled and patient Auto Ship orders will get free shipping but not 5% off. This is because patients will already be receiving the maximum discount amount available on every order.
Multi-Provider Tracking

If more than one health care provider at your practice will be selling supplements through our service, and you'd like to track sales by each provider, list the names of the providers as they should appear to patients.
List names if more than 1:
IMPORTANT: We will need a unique email address for each provider to register them in our system.
Multi-HCP 1: Provider Name Provider Email
Multi-HCP 2: Provider Name Provider Email
Multi-HCP 3: Provider Name Provider Email
Multi-HCP 4: Provider Name Provider Email
Multi-HCP 5: Provider Name Provider Email
Customized Banner

A banner will appear everywhere your patients interact with our service, including emails we send. Choose how you would like it to appear.
Please make a selection:*

Use the logo or graphics found on my practice website.Use a logo I will upload below.Create a "generic" banner with my name and practice name.Use the Doctors Supplement Store logo.
Comments/Requests
Upload Your Logo (if second option above is selected)
Coupons (optional)

We can create coupon codes for patient discounts. You may specify the dates available, minimum purchase amount, and a percent or dollar discount. We can create coupons for you at any time. Discounts come out of your earnings.
Select any coupons you'd like us to create:

Save 10% on your first order ("welcome" coupon)Save 10% on orders over $250
Describe any other coupons you'd like us to set up at this time. (See description above for options.)
Other Comments or Requests:

ALMOST DONE!

NOTE: You don't have to provide the documents below at this time, but we won't send earnings checks until we receive them.

To skip this for now, continue to the Submit Signup Form button on the last page.

You must click the Submit button to complete your signup!
LICENSE OR CERTIFICATION

We request a copy of your license or certification to be in compliance with certain manufacturers who exclusively sell to certified health care providers.
There are 3 ways to provide your license or certification:

1. Take a picture of it with your smart phone and email it to support@dssorders.com.

2. Scan it, save it to your computer and upload it below.

3. Fax it to 877-903-9290.
Upload Your License or Certification

W-9

This simple form instructs us how to report your earnings to the IRS, if required.
How would you like to submit your W-9?*

Fill out an electronic W-9 form (recommended)Fill out a paper W-9 form to upload, fax, or scan and email to us

W9: Request for Personal Taxpayer ID Number
IMPORTANT

We will need Your Name and SSN -OR- Your Business Name and EIN, but not both.

We need a single tax ID to report earnings against when required by the IRS.
To whom should we make out your earnings checks?*

Make earnings checks out to my businessMake earnings checks out to me personally

W9: Request for Personal Taxpayer ID Number
Your Name (exactly as shown on your personal income tax return)
Social Security Number XXX-XX-XXXX
If you are completing the W-9 at this time, by submitting this form you attest the following:

Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

W9: Request for Business Tax ID Number
Your Business Name (exactly as shown on your income tax return)
Employer Identification Number (EIN) XX-XXXXXXX
Enter your tax classification
Check appropriate box for federal tax classification*

Individual/sole proprietor or single member LLCC CorporationS CorporationLimited Liability company. *Enter Classification Below
* If Limited Liability company checked above Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
If you are completing the W-9 at this time, by submitting this form you attest the following:

Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

W9: Request for Taxpayer ID Number
IMPORTANT

We will need Your Name and SSN -OR- Your Business Name and EIN, but not both.

We need a single tax ID number to report earnings against when required by the IRS.
1. Download the W9 form here AND THEN:

2. Scan it, save it to your computer and upload it below.
3. Scan it and email it to support@dssorders.com
4. Fax it to 877-903-9290.
Upload completed W-9

Payment Address
Where should we send your earnings checks?
Send to my practice address
Street Address (if not sending to practice address)
City, State, and ZIP code

Last Step -- Just Click Submit!

When your form has been submitted, you will see a Thank You message.
Special Referral Source
referral follow up template
DSS reply email (hidden)
example@example.com
Should be Empty:

About Your Practice

Brand Selection

Orientation

Customizing Your Store

Website Address for Your New Store

Notification Email Address

Site-Wide Discount (optional)

Multi-Provider Tracking

Customized Banner

Coupons (optional)

LICENSE OR CERTIFICATION

W-9

W9: Request for Personal Taxpayer ID Number

W9: Request for Personal Taxpayer ID Number

W9: Request for Business Tax ID Number

W9: Request for Taxpayer ID Number

Payment Address