First Name *

Last Name *

Customize your OOFOS.com link! Type ONLY ‘yourbusinessname’ for OOFOS.com/#yourbusinessname *

Username (Email) *

Company Name

Web URL

Main Location Street e.g. “1234 Recovery Road Ste. A” *

City *

State *

Zipcode *

Direct Contact Number (No prompts) *

Inquiry Type *

How did you hear about the OOfiliate Program? *

Could you please describe what you do within the medical/wellness industry? *

How many locations do you own and/or operate out of? N/A if not applicable. *

Please list ALL additional practice/business locations here. If only one location, enter N/A. *

Are you owner, co-owner, or someone that can speak on behalf of the business? *

Yes , I am the owner. Yes , I am a co-owner. Yes, I can speak on behalf of the company. No, but I would like to learn more about the program.

Do you have relationships with specialty stores or a local run shop? Please specify. *

OOFOS Sandal Size *

OOFOS Sandal Style Preference (*Complimentary pairs are only provided upon approval.) *

I agree to the terms & conditions *