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Doctors Supplement Store Online Signup
FREE, no-risk setup (U.S.-based healthcare professionals only)
Please email of call if you need assistance.
Please provide an additional contact, such as an Office Manager, if applicable.
View our Terms of Service. (Recommended)
** Easiest for your patients --> Select *only* the brands you know and trust!
IMPORTANT: THIS IS NOT A PERCENT OFF THE RETAIL PRICE. (See example above.)
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!
There are 3 ways to provide your license or certification:
1. Take a picture of it with your smart phone and email it to email@example.com.
2. Scan it, save it to your computer and upload it below.
3. Fax it to 877-903-9290.
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.
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.
Enter your tax classification
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 firstname.lastname@example.org 4. Fax it to 877-903-9290.
Where should we send your earnings checks?
Last Step -- Just Click Submit!
When your form has been submitted, you will see a Thank You message.