Form cover
Page 1 of 1

Supplier Onboarding Form

Business Information

Business Name (English)

Business Name (Arabic)

Company Logo

Phone Number

(WhatsApp required to receive notifications)

Email Address

Office Address (TRN Registered)

Warehouse Address

Working Hours

(Example: Mon–Sat: 9:00 AM – 7:00 PM)

Primary Contact Person

Enter the details of the authorized person responsible for approving this partnership.

Contact Person Name

Contact Person Role

Contact Person Phone Number

Contact Person Email

Legal & Compliance

Trade License Number

Upload Trade License

Tax Registration Number (TRN)

Upload VAT Certificate

Brand Authorization Letters (if applicable)

(Upload authorization letters for all brands you are distributing).

Banking Details (Payout Info)

Bank Name

Account Holder Name

IBAN

Account Number

Please ensure all banking details are correct. ClinicSaver FZ-LLC is not responsible for failed transfers due to incorrect information. All information is kept confidential and used only for onboarding and verification purposes.

Final Confirmation

I confirm that the information provided is accurate and that I am authorized to represent this company.

I confirm that the information provided is accurate and that I am authorized to represent this company.