Doximity for Free Clinics: Intake Form
Hi there! 👋 Thank you for your interest in Doximity for Free Clinics.

We'd like to support the care you provide by offering an integrated suite of telehealth and AI tools to help you save time and focus on patient care. 

This program now includes three powerful, completely free tools for all verified clinician members:
  1. Doximity Dialer: a simple, secure way to conduct telehealth visits from your own phone and desktop, protecting your personal number.
  2. Doximity Scribe: a new AI-powered clinical documentation tool that securely and privately listens during patient visits and drafts your notes in real-time.
  3. Doximity GPT: our new generative AI tool designed to assist with a variety of administrative and clinical tasks. Use it to draft patient communications, summarize academic articles, or create practice guidelines—all with the confidence that it is built on a foundation of clinical knowledge.

đź“ť Please complete the fields below and a member of our team will reach out to you.
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First Name *
Last Name *
Contact Email *
Free Clinic Name *
Free Clinic Website *
Tax ID Number *
Before submitting, please confirm the following. *
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