Get Started with ClinicInfo

Please tell us a few things about your clinic to get started with ClinicInfo. If you are a Patient please visit the Patient Website.

Primary Account Contact

Please provide a primary contact for billing and support. This information will never be shared with third-parties and will not be displayed to patients. Prefix: First Name: Last Name: Email Address: example@email.com Password:
Repeat Password:

Passwords must be at least 8 characters long and include at least 1 uppercase letter, 1 lowercase letter, and 1 number or special character.

Telephone Number: 555 - 555 - 5555 Fax Number: 555 - 555 - 5555 I am a:

Would you like to create an additional account?

You can add more accounts for your clinic's staff later in your Clinic Settings. No thanks Yes, create another account

Clinic Information

Your clinic's information will be visible to Patients. You can edit it at any time in your Clinic Settings. Physician/Clinic Name:
Shown on notifications - e.g. 'Message from your Doctor: [name]' Specialization: Clinic Telephone Number: 555 - 555 - 5555 Clinic Fax Number: (Optional) 555 - 555 - 5555 Timezone of Your Clinic: Website: (If Applicable) Clinic Business Hours: e.g. 9am - 5pm Monday to Friday, closed weekends Address Line 1: Address Line 2: City: Country: Province/State: Province: State: Postal/Zip Code: Find the Clinic / Buzzer Instructions: (Optional) e.g. Take the South Tower elevator to the 7th floor and turn right. Please see the receptionist. e.g. Take the South Tower elevator

Invitation Code (optional)

If you received an invitation code from us please provide it below. You may still register without a code. Invitation Code:

ClinicInfo Terms of Service

Please read and agree to our Terms of Service to continue

I acknowledge that I have read and fully understand this consent form.
I understand the risks associated with the electronic communication between the clinics and patients, and consent to the conditions outlined herein.

I understand and agree to the ClinicInfo Terms of Service

Creating Your ClinicInfo Account...