Request for Additional Medtech Evolution Cloud License(s)

 
 
Practice Name*
 
 
Customer ID*
 
 
 
Your Name *
 
 
Your Position*
 
 
 
Email Address*
 
 
Phone Number*
 
 
 
 
 

I/We require an additional Medtech Evolution Cloud licence(s). 

The Medtech Evolution Cloud licence includes a setup cost of $500 + GST per Evolution licence plus a Cloud configuration cost of $200 + GST per licence.

Ongoing monthly fees include $95 + GST per Evolution licence and a Cloud hosting fee of $130 + GST per licence.

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 ($130+GST per month) is included in your total Evolution Cloud license fee ($225+GST per month per license). Your practice will require an additional Cloud Named-user Login at $65+GST per month for the second staff member. 
  
How many Medtech Cloud licences do you require?*
 
 
 
 
 
Medtech Evolution Cloud Login Details

Please enter the staff information in the field below for each of the Medtech Evolution Cloud licences requested above:

1. Staff Name
2. Role
3. Email Address     
 
Staff details for Evolution Cloud licence(s)*
 
 

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. 
 
 
 

To facilitate this process please complete the following steps: 

1. Within Medtech Evolution go to the Help Ribbon and select the "License / View License Details” option, and then click “Print” 

2. Rather than printing the screen, choose the option to Save to PDF. (This will only work if you have a PDF printer enabled.) Alternatively, take a screen shot of the licensing form. 

3. Attach either document to this form and press the submit button.

NB: If you require any assistance please contact our support team at support@medtechglobal.com
 
 
 
 
Upload a copy of your current Medtech Evolution licensing screen *
 
 
 
 
 
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