Practice Onboarding

Get Your Referral Portal Set Up

Fill in the form and we'll have your branded portal live within 24 hours.

Your Contact Details

The person submitting this application.

Full Name *

Email Address *

Phone Number

GDC Number *

Principal dentist or responsible clinician

Role

Practice / Group Name *

Number of Sites

Practice Website

Preferred Portal Address

.practicedomain.com

Your referral portal will be hosted at name.practicedomain.com. We'll configure DNS during setup.

How referring dentists will contact you. Shown on your portal and referral communications.

Practice Phone

Practice Email

WhatsApp Number

Practice Address

Optional — you can provide these now or we'll apply them during setup.

Practice Logo

Brand Colour

#7c3aed

Select all that apply.

Add the people who will manage your portal.

Administrator

Full access — manage referrals, settings, and staff accounts.

Staff

Referral access only — view and process referrals.