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Supplier application

Tell us what you provide and how you can serve international medical travelers. This application is for hospitals, clinics, recovery services, interpreters, hotels, concierge, insurance, and other travel support partners.

Supplier type

Organization

Public display name *Legal entity name *City *Ownership / business typeWebsite or public profile

Capabilities

Service description *

Verification and operating rules

License / credential summary *

Weekly lead capacityResponse SLA hoursExpected commission %

Contact and languages

Contact name *RoleEmail *Phone

Languages supported

Documents needed after submission

Business license or registration proof

Medical permits and doctor credentials where applicable

Service insurance or operational qualification where applicable

Facility, room, vehicle, or service photos

Public pricing or package guidance

Data privacy and patient communication contact

Commercial terms are not final in this form. Commission, settlement timing, escrow handling, refund rules, and lead allocation priority will be confirmed during partnership review.

I confirm the information provided is accurate and agree that TripNCure may review credentials, service scope, compliance fit, and distribution suitability before approval.