PRIVATE PILOT APPLICATION

Apply to join the ClinicaVox pilot

Provide the business and contact information needed to assess and administer your application. The longer workflow survey is intentionally deferred. Never submit patient information here.

ClinicaVox currently supports Windows pilot environments. macOS support is planned. If accepted, your business record will be linked to the unique licence ID provided in your activation email and local licence.

Applications are not open yet. The form is shown for review, but submission will remain disabled until the legal business name, mailing address, contact email, privacy contact, and Cloudflare D1 database are configured.

Step 1 of 2Business details

Your business details

Fields marked * are required. No patient information is collected here.

First name

Last name

Professional email

Clinic or business name

City

Province, territory, or region

Country

Professional role

Are you a registered physiotherapist?

Computer platform

The current pilot build supports Windows. macOS support is planned.