First Name
*
Last Name
*
Biocanic Login Email
*
Phone
Approximate Number of Clients
What is your Cer.bo patient portal URL?
*
Would you like to import existing clients?
*
Yes
No
Would you like Encounters to sync to Biocanic?
*
Yes
No
Would you like vitals to sync from Cer.bo?
*
Yes
No
Where would you like the link to the Biocanic account to be set?
*
Admin Notes
Need to Know
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Do you want Biocanic notes, to sync to Cer.bo encounters?
Yes
No
Do you want clients to receive the Welcome Email from Biocanic?
Yes
No
Do you want completed assessments in Biocanic synced to Cer.bo encounters?
Yes
No
By signing below, you hereby attest that you are an authorized member of the clinic to enable the integration to Biocanic
*
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