Registration form

Thank you for subscribing to Dental-Oracle!

Please fill in this form with your personal details, select your choice of subscription and your preferred method of payment. When you are done, please click the"Submit information" button.

As soon as we have received your payment, we will supply you with a personal username and password.

Please fill in the form:


Title:

First name:

Last name:

Name of clinic:

Address:

Zip and city:

State:

Country:

Phone:

Fax:

Email :

Internetaddress:

Membership of
dental societies:


Include in dentist directory:

Yes please

No thank you

Receive password by:

e-mail

fax

letter


Method of payment:

Money transfer or cheque

Mastercard/Visa


Subscription type: Price:
1 year

144.00 Euro

* Website + 1 year 678.00 Euro

VAT is not included in above mentioned prices.
Dental-Oracle is situated in Denmark, and thus danish residents are required
to pay the danish VAT of 25%. This amount will, for customers with
a danish address, automatically be added to the price at the invoice and when
paying by creditcard.

Furthermore, VAT is also required if subscription is not intended for a registered
clinic or company. To determine whether your subscription is for your private use
or for your professional use, we ask you to please check the proper button
below, and please enter your employers or clinics CVR/Tax number in the field.

We do not have the means to determine if you enter a valid CVR or Tax number
and the required danish VAT will simply be added if the field is left blank.


Register as:

Clinic

Single dentist

CVR/Tax number:


*

Let our staff of professional designers help you with your presentation of your clinic
on the internet. An example of this can be seen by clicking on the following link
Harry.dental-oracle.org. Of course this is just one example, and you are
free to choose from other designs, i.e. with more pages, and specific informations
when presenting your own clinic.

This price includes design and layout (you supply text and pictures) and installation
on the Internet on an address like yourname.dental-oracle.org. This presentation
will be made public in the dentist search engine with a selectable link.