KLINIKOS · CLINIC APPLICATION

Tell us about your clinic.

Submit the basic information below. This application does not create access to the KlinikOS workspace.

Secure application boundaryClinic documents, payroll information, staff IC and bank details are not requested at this stage. Supporting documents will only be requested after your application is confirmed.
NEW CLINIC APPLICATION

Apply for a KlinikOS trial

Fields marked * are required.

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01
Company & clinicBasic legal and operating information.
02
Main contactThe person we should contact about this application.
03
What you needHelps us prepare the right KlinikOS setup.
Modules interested in *Select the KlinikOS sidebar modules your clinic wants to use.
CORE · INCLUDEDStaff RegistryStaff identity, branch assignment and system access are included with every KlinikOS workspace.

Staff Registry is always included and is not a selectable subscription module.

Submitting this form does not create a KlinikOS username, password or authenticated web-app session.

APPLICATION RECEIVED

Thank you.

Your clinic application has been submitted for review.

Application reference

We will contact the PIC after review. Supporting documents will only be requested once the application is confirmed.

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