Apply to Join the CrossCare Network

Provide your organization's details. Progress is saved automatically to this device — you can return and complete the form later.

Organization details

Legal organization name *

Trading name

Organization type *

Year established

Registration number

Country of registration

Headquarters country *

City

Physical address

Website

General email

Main telephone

Primary contact

Full name *

Job title

Department

Business email *

Telephone

WhatsApp / WeChat (optional)

Preferred communication

Preferred language

Organization profile

Organization description

Countries served (comma-separated)

Languages supported (comma-separated)

Number of locations

Current international patient markets

Main specialties or services

International patient department availableRemote consultation availabilityVisa invitation-letter capabilityAirport transfer supportAccommodation supportInterpreter supportInsurance support

Partnership interests

Receive Patient ReferralsRefer Patients to Other ProvidersHospital PartnershipMedical Tourism PartnershipResearch CollaborationTreatment Marketplace ListingGlobal Hospital Directory ListingVisa Support PartnershipTravel PartnershipInsurance PartnershipTechnology IntegrationWhite-Label CrossCare PlatformOther

Supporting documents (optional)

Attach business registration, licenses, insurance certificates, or a company profile to speed up verification. Uploads are optional — you can also add documents later from the tracking page.

Document type for next upload

Drop files here or click to upload

PDF, JPG, PNG, WEBP, DOC, DOCX, XLS, XLSX · up to 15 MB each · max 10 files

Files are transmitted directly to encrypted storage using short-lived signed URLs.

Additional information

Why would you like to join CrossCare AI?

What types of patients or referrals are you seeking?

Which countries are your priority markets?

Additional comments

Consent

I confirm that I am authorized to submit this application on behalf of the organization.I confirm that the information supplied is accurate to the best of my knowledge.I agree that CrossCare may contact the organization regarding this application.I acknowledge that submitting an application does not guarantee approval.I have read the Privacy Notice and Partner Application Terms.