Partner Onboarding Form

Welcome to NADclinic Group

Please complete the form below to open your clinic account with us.

All product information, pricing and catalogues shared following registration are addressed strictly to licensed medical professionals and prescribing practitioners.

For any support, please contact partnerships@nadclinic.com for new accounts and partnerships, or orders@nadclinic.com for order enquiries.

Enter the company name exactly as it should appear on invoices and orders.
Primary contact for account management and order communication.
Full registered company address as held on official records.
As per registered address.
As per registered address.
Determines applicable shipping route and regulatory requirements.
Please include country dialling code.
Business email address. Used for order confirmations and account correspondence.
Full name of the licensed physician or prescribing nurse responsible for the account.
Registration number exactly as issued by the licensing authority.
For example, GMC (United Kingdom), NMC (United Kingdom), DHA or MOH (United Arab Emirates), HPCSA (South Africa).
Used for clinical correspondence and prescription confirmation. May differ from the account email.
Include country dialling code.
If you were introduced to NADclinic Group by a partner, practitioner or existing client, please enter their name.
Complete only where a commission or referral arrangement has been agreed with NADclinic Group. Leave blank if not applicable.
Submit