Request for Reduction of MedTech32 Licences

 
 
 
 
Customer No.*
 
 
 
 
Customer Name*
 
 
 
 
Requestor’s Name*
 
 
 
 
Requestor’s Position*
 
 
 
 
Email Address:*
 
 
 
 
Phone Number*
 
 
 
 
Date required to implement this reduction*
 
 
 
 
Number of licenses you wish to reduce by: *
 
 
 
 
 
 
 
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 accept the Privacy Policy and I am authorised to make this commitment on behalf of my organisation.*
 
 
     See Privacy Policy 
 

Please note: There is a 24 hour turn around period for new licence details being returned to the practice.

 
 
 
 
 
 
 
 
 
 

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