Thanks for supporting ClienTrax!

We're looking forward to your first case! Please complete the following registration details. We'll be in touch soon once we activate your account.

Clinic Information

Note: Your system username will be emailed to you after we activate your account.

Your Billing Information

When you sign up for credit card billing, your payment information will be stored on our third party service provider and charged when applicable.

Billing Address

Please enter the full billing address associated with this card.