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ClinicSaver - Partner Clinic Application

🏥 Clinic Information

Clinic name?

*

Clinic location? (City & Area)

*

(Example: Jumeirah 3, Dubai)

Clinic type?

*

Clinic type?

Aesthetic Clinic

Dental Clinic

Dermatology Clinic

Plastic Surgery Clinic

Wellness Clinic

General Medical Clinic

Hospital

Other

Working Hours?

*

(Example: Monday-Saturday, 10 AM - 8 PM)

👤 Contact Person

Full Name

*

Position at the Clinic

*

Phone Number (Whatsapp)

*

*You will receive Whatsapp notifications on this number for pending bookings*

Email Address

*

🖼️ Branding & Visuals

Upload Clinic Logo

*

(High Resolution)

Accepts .jpg, .jpeg, .png, .zip files

Upload Clinic Photos (Cover)

*

Accepts .jpg, .jpeg, .png, .zip files

💆‍♀️ Treatments Offered

Upload Your Treatment List

*

📎 Please upload an Excel, Word, or PDF file including the following columns (refer to the table below):

1. Treatment Name (do not use abbreviations)

2. Original Price (AED)

3. Discount (%)

https://storage.tally.so/ab5b42a6-b1b3-4998-91ae-0a8468233107/Screen-Shot-2025-05-14-at-12.24.25-AM.png

Accepts .pdf, .doc, .docx, .xls, .xlsx, .zip files

📄 Verification & Payout Details

Upload Clinic Trade License

*

Accepts .pdf, .doc, .zip files

IBAN

*

Account Name

*

Bank Name

*

📝 Final Details

Where did you hear about ClinicSaver?

*

Where did you hear about ClinicSaver?

A

Sales Visit

B

Instagram

C

D

Facebook

E

Referral

F

Email

G

Other