PurpleDocs - Telemedicine Enrollment forms for Care Providers
PurpleDocs is a health tech company that has come up with a Video Consultation and Digital Prescription platform where Patients suffering from chronic diseases can consult providers online.
Correo electrónico *
Doctor's Name *
Specialty *
Registration Number *
Total years of experience *
Doctor's Phone number *
Hospital / Clinic Name
Address
City *
State
Country
Pincode
Languages you can speak? *
Have you treated covid19 patients? *
Would you be able to provide remote assistance via video Consultation to Covid19 suspects and infected patients? *
How many hours are you available for teleconsultation?  Please specify the time slots (Morning, evening) *
How much would you charge for a 15 minutes video consultation?
Se enviará un correo electrónico con una copia de tus respuestas a la dirección que suministraste.
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