Skip to Content

Belvia MED Partner Application Form

Please read Terms & Conditions carefully before applying 

Application Form ​

Main Services you'd like to promote ​
Example: 5-year implant warranty
Average Monthly Number of Foreign Patients
for Online Consultations
How many days on average you need before the online call?
I authorize Belvia MED to use provided and created materials for promotional purposes in accordance with the Partner Terms & Conditions.

I have read and accept the Belvia MED Partner Terms & Conditions (version v1.0)

Submit

Digital Acceptance of Terms

By clicking the option “I have read and accept the General Terms and Conditions of Partnership with Belvia MED” and submitting the registration form, the Partner Clinic hereby declares its full consent to all provisions of this document.

Such electronic acceptance has the same legal effect as a signed contract in accordance with the Obligations Code of the Republic of Slovenia and the relevant EU regulations on electronic commerce (Directive 1999/93/EC and eIDAS Regulation 910/2014).