Partner Signup

Fields with an asterisk (*) are mandatory.

General

First Name *

Field is required

Last Name *

Field is required

Email *

Field is required

Email Confirmation *

Field is required

Phone Number

Company

Legal Entity Type *

Field is required

Full Legal Name (or Legal Entity Name) *

Field is required

Website/Social Media *

http(s)://

Field is required

Address

Address *

Field is required

Apartment, suite, etc.

Country *

Field is required

City *

Field is required

ZIP/Postal Code *

Field is required

Additional Information

Are you a certified medical professional? If yes, in what field? *

Field is required

Do you have a U.S. bank account and SSN? *

Field is required

Why are you interested in joining? *

Field is required

Are you promoting any other GLP1 brands? *

Field is required

How do you plan to promote OrderlyMeds? *

Field is required

Were you referred by another affiliate? *

Field is required

Which program are you applying for? *

Field is required

Social Media

TikTok URL *

Field is required

Instagram URL *

Field is required

Facebook URL *

Field is required

Additional Social Channel(s)

What is your total social media following? *

Field is required

Terms and Conditions

Error!

You must scroll and accept the terms and conditions to continue

Orderly Wellness Corporation Terms *

Welcome to the OrderlyMeds Affiliate Program. 
By accepting these Terms, you confirm you have read and agree to our full Partner Agreement, available at: https://orderlymeds.com/affiliate-program/Terms-Conditions 

Key points: 
- You are an independent contractor, not an employee 
- Prohibited: cookie stuffing, misleading ads, spam 
- Commissions are paid monthly for verified, non-reversed transactions 
- You must disclose affiliate relationships per FTC guidelines 
- We may terminate accounts for policy violations at any time 
- Updates to terms require re-acceptance if notified 

For the full agreement governing this relationship, 
visit: https://orderlymeds.com/affiliate-program-terms-conditions/

I agree to these Terms and Conditions.