Thanks for your interest in signing up for the Starter Plan

We're in the process of setting up a stream-lined payment system. Please leave your information below and a customer success agent will reach out to you to help you get your account set up. We will send you all the necessary documentation including a Business Associates Agreement (BAA) for signature prior to you uploading sensitive patient information.

CONFIDENTIALITY NOTICE: By submitting this form, you acknowledge and agree that you will not divulge any proprietary or sensitive information shared in relation to the services provided. You understand that such information is to be maintained in strict confidence and will not be disclosed, except with your prior written consent or as required by law. You agree to use the information solely for the purpose of engaging with the Company's services and not for any other purpose without the prior written consent of the Company. Furthermore, you consent to the Company reaching out to the entity for purposes related to the provision of services, including communication, support, and updates, based on the information provided. This agreement applies to all information provided through this form and remains in effect for the duration of the engagement between the Company and the recipient. By submitting this form, you agree to be bound by the terms of this Confidentiality Agreement.

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