Request for Additional Medtech Evolution Cloud Licence(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 cost of $500 + GST per Evolution licence plus a Cloud configuration cost of $200 + GST per licence.

Ongoing monthly fees include $70+ GST per Evolution licence and a Cloud hosting fee of $115 + GST per licence.

How many Medtech Cloud licences 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.
Acknowledgement of fees

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 then please click here to be redirected to our support page. From here you can chat online with our support team or submit an email.
Upload a copy of your current Medtech Evolution licensing screen *
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