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.

Join

Primary Doctor's Information

Primary Office Address

Address Line 1
Address Line 2
City
State
Zip Code
Country

Second Office Address

Third Office Address

Fourth Office Address

Fifth Office Address

Sixth Office Address

Office Manager Contact Information

A/P Contact

Supplier Information

Capital Equipment

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Terms and Conditions