Welcome to the KeborMed Partner Program Application!
Thank you for your interest in joining our partner program. Please complete the following survey with accurate and detailed information about your company. This will help us assess how we can best collaborate. Once you submit the survey, our team will review your application and get back to you shortly. We appreciate your time and look forward to the opportunity to work together!
Please enter the company name
Please select your country
Please enter your first name
Please enter your last name
Please enter a valid email address
Company Size and Structure
How many employees does your company have? *
(Mark only one)
Please choose the company size
What is the primary focus area of your company? *
(Check all that apply)
Please choose focus area
Experience and Certification
Select or add any relevant certifications your company holds. *
(Check all that apply)
Please choose certifications
Which healthcare or wellness clients have you worked with before?
Technical Proficiency
Which technologies are you proficient in? *
(Check all that apply)
Please choose technologies
Rates and Engagement Models
What is your standard hourly rate range? *
(Mark only one)
Please choose hourly rate
Preferred engagement model for projects *
(Check all that apply)
Please choose engagement models
Team Location and Working Hours
Please indicate the primary geographical location(s) of your team. *
(Check all that apply)
Please choose locations
Select the time ranges during which your team is generally available, according to Pacific Standard Time (PST).*
(Check all that apply)
Please choose working hours
Does your team work in countries that are sanctioned by the US? *
(Mark only one)
Please choose sanctioned
If you have answered "Yes" to the previous question, please provide details.
Additional Comments
Please share any additional comments or information that you feel is pertinent to this partnership.
* Mandatory