Virtual Care Providers Information Form Step 1 of 3 33% Company Name* Primary Contact Person* First Last Contact Email Contact Phone Website Short Company Description*Company logo*Accepted file types: jpg, gif, png, jpeg, Max. file size: 8 MB.Please upload a copy of your company logo. This file may be edited to fit into the directory. How would you like people to contact you? Email Phone Website Select all that apply Service Type Teleconsulting Telemedicine Teleadvice / Teletriage Telemonitoring Other Virtual Care Service Select all intended users Consumers Individual Veterinarians Veterinary Clinics (All staff) Industry Groups (Large pet product companies, retailers, insurance, etc.) Service Methods Live Video Phone Call Email Text Messaging Live Chat Asychronous Messaging Mobile App Select all that applyBusiness Model Fee for service Monthly plan Customized per account Free resources and education Non profit n/a Supported Technology Andoid Mobile App iOS Mobile App Google Chrome Web Browser Other Web Browser Other Other Support Technology Select all features supported Appointment Scheduling Photo Attachments Video Attachments PMS/EMR Integration Prescription Fullfillment Other Other features supported Link to Demo Video Fee per Interaction/Use Other Fees or Surcharges Credit Card and Transaction Fees Briefly explain how and when Select all payment processors Paypal Stripe Square Bluesnap WePay Adyen Other List other processors How long is client and patient relationship? Can any client or patient data be shared? No Yes If Yes, explainSelect all applicable security Anonymized Patient Data GDPR Compliant PCI Compliant Secure Connection Verification SOC Certified SSL/TLS Encryption Protocols PHIPA/PIPEDA Compliant HIPAA Compliant Other List Other security features PhoneThis field is for validation purposes and should be left unchanged. Who should submit a listing This directory is for all virtual care technology companies. Please complete the form and we will contact you with any questions or concerns. Your placement will appear once we've reviewed your information.