Virtual Care Providers Information FormStep 1 of 333%Company Name*Primary Contact Person* First Last Contact Email Contact Phone Website Short Company Description*Company logo*Accepted file types: jpg, gif, png, jpeg.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 WebsiteSelect all that apply Service Type Teleconsulting Telemedicine Teleadvice / Teletriage Telemonitoring Other Virtual Care ServiceSelect 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 AppSelect all that applyBusiness Model Fee for service Monthly plan Customized per account Free resources and education Non profit n/aSupported Technology Andoid Mobile App iOS Mobile App Google Chrome Web Browser Other Web Browser OtherOther Support TechnologySelect all features supported Appointment Scheduling Photo Attachments Video Attachments PMS/EMR Integration Prescription Fullfillment OtherOther features supportedLink to Demo Video Fee per Interaction/UseOther Fees or SurchargesCredit Card and Transaction FeesBriefly explain how and whenSelect all payment processors Paypal Stripe Square Bluesnap WePay Adyen OtherList other processorsHow long is client and patient relationship?Can any client or patient data be shared? No YesIf 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 OtherList Other security featuresNameThis field is for validation purposes and should be left unchanged. Who should submit a listingThis 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.