Affiliate enrollment

Create your free Affiliate account

No payment method is required. There is no Stripe checkout, no subscription and no membership purchase required to become a Connect Med Affiliate. Tax information is collected at the appropriate stage before payout.

First name

Last name

Mobile phone

Address

City

State

ZIP

Date of birth(optional)

Social handle(optional)

Website(optional)

How did you hear about us?(optional)

Create a password

Minimum 8 characters. This is your partner dashboard login.

How do you plan to promote Connect Med?

Program agreements

I accept the Affiliate AgreementI accept the FTC Disclosure PolicyI accept the Marketing Compliance PolicyI acknowledge the Independent Contractor NoticeI accept the Privacy PolicyI accept the Payout & Tax TermsI consent to the Electronic Communications Consent

Affiliate registration is automatically provisioned after required agreements are accepted, unless compliance rules require manual review. Referral compensation is paid only on qualified referrals under existing Connect Med program criteria.