MediScribe AI - Your AI Medical Assistant

Join as a Sales Representative

Earn commission by referring doctors to MediScribe AI

First Name *

Last Name *

Email *

Phone Number *

South African ID Number *

Required for tax reporting purposes

Commission Model *

One-Time Commission50% of first month paymentExample: R2,500 for Solo Plan (R4,999/month)

Recurring Commission10% per month for 6 monthsExample: R500/month × 6 months = R3,000 total

• Annual Contracts: 15% commission
• Volume Bonus: R500 (5+ signups), R1,500 (10+ signups), R3,000 (20+ signups per month)
• Group Practice Bonus: 20% extra for multi-doctor practices

Bank Name *

Account Type *

Account Number *

Branch Code *

Province *

City *

Estimated Network (Optional)

Help us understand your network of potential referrals

Additional Notes (Optional)

I agree to the Sales Representative Terms & Conditions and understand that commissions are subject to a 30-day clawback period if customers cancel.

Please fill in all required fields and agree to the terms & conditions

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