Medical provider questionnaire

Join Medical Departures for FREE Today!

Thank you for your interest in becoming a medical provider with Medical Departures . We will use the information in this questionnaire in part to determine if we select your medical clinic to partner with and refer patients to. Please answer the following questions as completely and accurately as possible.

You will receive a reply back from Medical Departures within 7 business days. If you have any questions please e-mail: questionnaire@medicaldepartures.com or call

Join Medical Departures for FREE Today!

Medical Departures is the #1 site to find a global clinic. When our customers visit a global clinic they save 70% on their medical care. Medical Departures partners with 4250+ clinics in 33 different countries around the globe.

Why become a Medical Departures partner?

  • Medical Departures is #1

    Medical Departures is #1

    We are the #1 place for patients to find global clinics
  • No set-up fees

    NO set-up fees

    No set-up, monthly, annual or premium listing fees
  • Pay for completed appointments

    Pay for completed appointments

    Pay Medical Departures a commission
  • Patients pay you

    Patients pay you

    Patients pay your clinic and then your clinic pays Medical Departures a commission afterwards
  • FREE photos

    FREE photos of your clinic

    Medical Departures takes high resolution photos of your clinic *only specific countries
  • 24/7 customer care support

    24/7 customer care support

    Customer care for your patients and your clinic
  • Appointments are FREE

    Appointments are FREE

    Customers do not pay to schedule an appointment
  • Multi-currency pricing

    Multi-currency pricing

    Your medical clinic pricing will be priced in 8 different currencies
  • Contact Information
  • Clinic Details
  • Legal
  • Doctors

Contact Information

Clinic Information

Legal

Doctors