Distributor registration form

Dr. Goods is interested in finding long-term and reliable partners worldwide.

Please, fill out the form below if you are interested in distributing our product range.

We shall review the form and contact you shortly.

    Name Surname*


    Company*


    Company History or overview (optional)


    Telephone*


    Email*


    Company Website*

    Country*



    Area of Representation (Countries)*



    Currently a Distributor*


    Please, provide name of companies distributed (optional)


    Area of Interest. Please provide at least 5 codes from the catalogue*