Customer registration

Register as a Brainz customer.

Set up your hospital or company as a registered customer of Brainz Medical Technology. Complete the form below, or download our Excel template, fill it in and upload it. Once we receive your details, our team finalises your account and gets back to you.

Two ways to register. Fill the form below, or download the Excel template, complete it offline and attach it in the upload field.
Download Excel template
1Your location & type
2Company & contact
3Tax & banking
4Notes & documents optional
Sent securely to our team. Your details are not published anywhere.