Membership Form

Please fill out the following form. Once we have received your member application, you will receive an email with our welcome packet that provides instructions on how to begin savings and taking advantage of your membership.

Please also review our IDS Member Services Agreement (MSA).

‚ÄčIf you have questions or need assistance with the form, please contact us.

Illinois Dental Solutions Join

Primary Doctor's Information

Please note you must be a ISDS member to join Illinois Dental Solutions. To become a ISDS member, please visit:

Primary Office Address

If you have multiple practices, please provide the address information for all practice locations in the additional address fields.
Address Line 1
Address Line 2
Are you an ISDS member?

As an Illinois Dentist, you must be an ISDS member to
join. To become/renew your ISDS membership, please visit:

Zip Code

Second Office Address

Third Office Address

Fourth Office Address

Fifth Office Address

Sixth Office Address

Office Manager Contact Information

Ordering Person's Contact Information

Supplier Information

Capital Equipment

If you selected "YES", we will tag your practice's Facebook page on our post, if available.

Terms and Conditions