List your practice

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List your practice

Please provide the requested information

Email *

Are you listing as an individual medical professional or as a clinic/hospital? *

Clinic

Hospital

Medical Professional (e.g Doctor)

Please describe your specialty *

Would you like to offer Telemedicine: *

Yes

Do you accept any insurance? If so, please state which ones *

Please write a brief overview Clinic/Hospital. At most two paragraphs that briefly provide a clear overview the Clinic/Hospital. For example: “Goodcare clinic is fully registered and certified clinic that offers world class medical treatment at affordable costs. We have state of the art facilities and medical equipment ..."

Consultation Fee (If applicable)

Please specify your availability *

Please provide any comment you think is necessary

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