A New Portal for a New Partnership
Think you are a good fit?
Thanks to the new Partner Program Portal, potential partners can now submit their software module for consideration by filling out the form below.
Company Name*
Address*
Website
Contact First Name*
Contact Last Name*
Contact Phone*
Contact Email*
Contact Mailing Address (If Different)
Contact Fax
Contact Title*
Company Information*
Number of Dental Practice Customers*
-- Select an option --
1 - 50
51 - 100
101 - 500
501 - 1,000
More than 1,000
Solution Name
Solution Summary*
Solution Description*
Solution Category*:
-- Select an option --
Revenue Cycle Management
Patient Engagement
Data and Analytics
Clinical Solutions
SIGN*
Date*
Carestream Dental LLC Privacy Statement
I acknowledge that I have reviewed and agree to the Privacy Statement.
Carestream Dental Confidentiality Statement
I acknowledge that I have reviewed and agree to the Confidentiality Statement.
Submit
