medi Connect application

medi connect is an eCommerce website built for medi premier partners to enhance the patient experience while offering the medi customer business solutions.

*Full offering of medi compression portfolio

*Inventory management

*Cash flow benefits

*Connect with patients long term with added value programs

Name of Clinic or Business*

Current business website URL*

medi account number if have one

Primary business address*

Primary City*

Primary State*

Primary zip code*

Owner name*

Owner email*

Owner phone number*

Implementation contact*

Implementation email*

Training contact name*

Training contact email*

Number of locations*

I understand the medi Connect program requires an internet connection and medi does not supply connectivity hardware.*

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I understand this is a retail transaction and medi products can be subject to state and local sales taxes. Please contact your tax adviser if you have questions. Employees of medi USA are not permitted to provide tax guidance.*

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I understand the medi Connect program utilizes the Shopify platform. All Shopify monthly service and transaction fees are responsible of the account owner.*

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I understand to operate the medi Connect program I need a retail sales license and a merchant account for processing transactions. If Shopify does not support the account merchant processing company, account will agree to use Shopify credit card processing system.*

List of supported Shopify payment merchant go to shopify.com/payment-gateways/united-states

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I agree to a one day on site training program conducted by medi personnel for product and transaction training purposes. Account agrees to dedicate a primary administrative direct employee for site set up and customer service training.*

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Primary product collections: eg - 20-30mmHg Thigh

Provide up to 5 product categories you wish to highlight on home page (example, mediven comfort, circaid juxtalite, accessories, mediven for men classic)

Upload any images or logos you wish to use on the home page

Drag and drop files here or

Please indicate your primary reason for implementing medi Connect.

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