Request for Additional Medtech32 License(s)

Customer No.*
Customer Name*
Requestor’s Name*
Requestor’s Position*
Email :*
Phone Number*
Date required for this to be actioned*
I/We require an extra Medtech32 license(s). 
How many licenses do you require?
Upload a copy of your current Medtech32 licensing screen*
Upload a screenshot of your current MT32 License*

Note: Go to Help/Register option on the Menu Bar and use a snipping tool to take a screenshot. If the snipping tool is not available, please do CTRL + SHIFT + Print Scrn and then paste it on a word document. Please save it on your computer and upload that file

Privacy Policy
I have read and accepted the Privacy Policy*
I have full authority make this commitment on behalf of my organization*
I/We acknowledge the $57.90 + GST per license for the Annual Maintenance Fee on all new Interbase Licenses *
I/We acknowledge that our monthly support and development fees will increase by the number of workstation fee per additional license as requested*
     See Privacy Policy 


Note: Your request will be processed within 1 business day.