Contact Information:
Your Name (required):
Your Email (required):
Your Telephone Number (required)
Your Clinic Name (required)
Your TELUS Client ID Number
Your TELUS Health EMR ---PS SuiteMed Access
Your Ocean Site Number (Please enter 0 if you do not have an Ocean site)
Clinic Address:
Province:AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon
I am interested in ordering the following:
Floor Stand Kiosk Bundle Countertop Kiosk Bundle
All bundles include:
Demo confirmation:
To ensure the Check-In Kiosk solution meets the needs of your clinic, please confirm one of the following: ---Yes, I have seen a demo of the Check-In Kiosks.No, I have not seen a demo of the Check-In Kiosks. Please contact me to set one up. If you selected yes, please confirm who lead the demo: ---Ocean by CognisantMDTELUS Health RepresentativeOther
If you would like to purchase your own tablet, please do so after consulting with TELUS Health to ensure you have purchased the correct model that fits in the hardware.