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.

If you are an ISDS member, please fill out the form at: ISDS Join Form

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

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


Primary Doctor's Information

Primary Office Address

If you have multiple practices, please add each practice's address to 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

Ordering Person's Contact Information

Supplier Information

Capital Equipment

If you selected "Other", please indicate how you heard about us in the other comments section below.
If you answered yes, we will tag your practice's Facebook page on the post if available.

Terms and Conditions