Quraco | Affordable Clinic Spaces for Doctors, No Long-Term Commitment

Clinic Information

Clinic Name / Brand Name *

Personal Information

Full Name *

Date of Birth

Gender *

Contact Details

Email ID *

Phone Number *

Clinic Address

City *

State

Pin Code *

Country

Professional Information

Qualification

Specialisation

Years of Experience

Certifications

Clinic Description

Current Speciality Practised and Type of Services Offered *

Number of Cabins Available for Tie-up

Washroom Available? *

Yes

No

Waiting Area Seating Capacity

Do you have staff to manage Quraco appointments?

Yes

No

Age of the Clinic (in years)

Clinic Floor

Space Schedule and Availability

Hours per day you can list your space

Days per week

Document Uploads

Clinic Owner Degree Certificate

PDF, JPG, PNG accepted

Clinic Registration Certificate

PDF, JPG, PNG accepted

Clinic Interior Photos (Reception & Washroom)

JPG, PNG accepted (Multiple files allowed)

Clinic Exterior Photos

JPG, PNG accepted (Name board & surrounding area)

Clinic Onboarding Form