Request for Additional Cloud Named-user Login(s)

 
 
Practice Name*
 
 
Customer ID*
 
 
 
Your Name *
 
 
Your Position*
 
 
 
Email Address*
 
 
Phone Number*
 
 
 
 
 
I/We require an additional Cloud Named-user Login(s). 

Medtech Cloud Named-user Login fees are $50+ GST per login setup, with an ongoing monthly fee of $60+ GST per login per month.

PLEASE NOTE: For data protection, privacy and security, cloud logins are allocated individually to named-users and cannot be shared. For example: if your practice has two staff members working part time and sharing a Cloud Evolution license installed on one work station, one Cloud Named-user Login ($125+GST per month) is included in your total Evolution Cloud license fee ($210+GST per month per license). Your practice will require an additional Cloud Named-user Login at $60+GST per month for the second staff member. 
 
How many Cloud Named-user Logins do you require?*
 
 
 
 
Please allow 24 to 48 hours for us to action your request.

PLEASE NOTE: Licence fees are charged monthly. Regardless of the date on which you request an additional licence you will be charged the full monthly fee. To optimse your charges, we recommend requests for additional licences are submitted at the beginning of the month. 
 
 
 
Cloud Named-user Login Details
Please enter the following information in the field below for each of the Cloud Named-user Logins requested above:

1. Staff Name
2. Role
3. Email Address 
 
 
 
Staff details for remote licence(s)*
 
 
 
 
 
Privacy Policy
 
 
I have read and accept the Privacy Policy and I am authorised to make this commitment on behalf of my organisation.*
 
 
 
See Privacy Policy