It’s easy to apply for Red Tray membership! Just complete the short application below, click ‘Next’ to select the suppliers you wish to set up to bill through Red Tray, then click ‘Submit’ to send your information for processing.

Or, if you prefer, call 800.416.7676 for a fax-back application.

If you have any questions or need assistance, just call Red Tray Member Services at 800.416.7676.

Membership Application
All Fields Required
Principal Owner's Name
Title OD    MD    Optician  
Years In Practice   Years At This Location
Date Of Birth - - (mm-dd-yy)
Practice Name
“Bill To” Name
E-Mail Address
Office Phone Number (no dashes)
Office Fax Number (optional) (no dashes)
Type Of Practice: Solo OD Group OD Optician
Solo MD Group MD MD/OD
Social Security # (no dashes)
Federal Tax ID # (no dashes)
Billing Address  
State Zip Code
Shipping Address (if different from above)
State Zip Code
Owner’s Home Address (required for credit verification)
State Zip Code
Home Phone Number (no dashes)
Level of monthly credit you wish approved: $100-$999
Do you currently belong to any buying groups? Yes    No
How did you hear
about us?
Name of specific source:

Terms And Conditions
First Name   Middle Initial   Last Name
First Name   Middle Initial   Last Name