Doctor onboarding

Doctor Information Collection - QR Doctor’s Portfolio Page

✓ Your information is handled securely

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Let’s get to know you

Doctor information

These details will shape your patient-facing QR profile.

Full name *

Please enter at least 3 characters.

Qualification(s) *

Example: MBBS, MD, DM, MS, DNB, MCh, FRCS

Specialization(s) *

Separate multiple specializations using commas.

Short bio *

Minimum 50 characters · Maximum 10000 / 1000

Doctor photograph *

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Drop photo here or browseJPG or PNG · Maximum 5 MB

Visiting card / prescription pad *

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Drop file here or browseJPG, PNG or PDF · Maximum 10 MB

Clinic / hospital name *

Consultation time *

Clinic / hospital address *

Mobile number *

Indian mobile number · optional +91 country code

Services provided *

Separate multiple services using commas.

Preferred QR code format *

Printed postersA5 stickers for walls, desks and reception

Durable PVC QR standReady-to-place tabletop display

Social media links Optional

Website

Facebook

Instagram

YouTube

Twitter / X

Google Business Profile

Additional information Optional

For internal purpose only

Internal routing

Choose your division to load the latest territory hierarchy from Google Sheets.

Division *

* Required fields