Onboarding Request Form
In order for us to install the AutoPrax software, we require some information to set things up and make sure your billing is using the correct tariffs.
Please complete all the required information below and email the completed form to Lizanne Coetzee (lizanne@autoprax.co.za). Please also attach any medical aid contracts and your letterhead as a jpeg.
Should you have any queries or concerns about the information we are requesting, please do not hesitate to email Lizanne or phone us at 012 943 8383.
We will always keep your information private and secure and in line with the POPI act.