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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)
*
Email Address
*
🖼️ Branding & Visuals
Upload Clinic Logo
*
(High Resolution)
Click to choose a file or drag here
Accepts .jpg, .jpeg, .png, .zip files
Upload Clinic Photos (Cover)
*
Click to choose a file or drag here
Accepts .jpg, .jpeg, .png, .zip files
💆♀️ Treatments Offered
Upload Your Treatment List
*
📎 Please upload an Excel, Word, or PDF file including the following columns:
1. Treatment Name
2. Original Price (AED)
3. Discount (%)
Click to choose a file or drag here
Accepts .pdf, .doc, .docx, .xls, .xlsx, .zip files
📄 Verification & Payout Details
Upload Clinic Trade License
*
Click to choose a file or drag here
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
WhatsApp
D
Facebook
E
Referral
F
Email
G
Other
Submit
