Get the Cobility™ Plugin

We'll have you up-and-running in no time.

$250 per month
for first location

Organization Name *Name of your practice or organization.
Contact Person Name of the person whom the invoices will be going to be sent to.
Organization Address *
Address of the main location if client has more than 1 clinical address.Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone *
Email *Email address of the contact person whom the invoices will be sent to.
Plugins / Modules / Services *
Check all plugins you want added.Cobility™ Referral Management
Please tell us which locations you'd like this implemented.
You can list specific locations, or tell us to implement for all your locations.
How many locations do you want activated? *You may have 50 locations, but perhaps you only want 5 locations using this plugin.
Please tell us anything here.
Subscription *
Would you like to commit annually and get free implementation? (save $500) Or would you prefer to go month-to-month?Annually - Bill me now $3000 for the first location, plus $50 for each additional location noted above, and continue annually. (no implementation fee!)Monthly - Bill me now $500 for implementation and setup, $250 for the first location, plus $50 for each additional location noted above, and continue monthly.

Terms and Conditions. *
By subscribing to a Plugin or Service (the Module), you are requesting the Company add the Module, and its’ associated fee(s) (the Addendum) to your existing Software Acquisition Agreement and Licensing Agreement (“Licensing Agreement”) with the Company. Use of the Module is provided, permitted and governed by the terms of the Licensing Agreement. By agreeing to the terms and condition above, you are agreeing to this Addendum to the Licensing Agreement, and reaffirming all other of its original terms. In no way limiting or modifying the terms of the Licensing Agreement, we provide the following general disclosures: Due to the time-consuming nature of software integration, it will take our team time to install, configure, and test all plugin implementations. Therefore we cannot refund implementation fees under any circumstances. All monthly or annual subscriptions are pre-paid services and cannot be cancelled nor refunded. All monthly or annual subscriptions shall renew according to the terms of the Licensing Agreement. By agreeing to the terms and condition above, you are agreeing to this Addendum to the Licensing Agreement, and reaffirming all other of its original terms.Yes, I agree to the terms and conditions listed above.
Electronic Signature *Please enter your full name above. This is considered your legal consent and endorsement and will be accepted as your written signature.