SCD Application/Sign Up Form - Southern Cross Dental New Zealand

Personal Information

Dental Council of NZ registration number*

0 of 5 max characters

Lookup DCNZ

Full Name*

0 of 45 max characters

I'm not a dentist

Preferred name

0 of 45 max characters

Dentist Email*

Does your practice belong to a Corporate Group?

Yes

No

Trading Name*

0 of 100 max characters

NZBN*

Lookup New Zealand Business Number

Have you had an account with SCD before?

I already have an account with SCD in the past

CAPTCHA

Practice Details

Practice Name*

0 of 45 max characters

Practice Address*

0 of 45 max characters

Practice Address 2

0 of 45 max characters

Suburb*

Town/Region*

Postcode*

0 of 4 max characters

Is your Delivery Address different to your Practice Address?

Practice Phone*

Practice Contact Name

0 of 45 max characters

Position

0 of 45 max characters

Digital Scanners

Trios

CS-Connect

Sirona-Connect

iTero

MeditLink

DEXIS

Other

How to connect your scanner with SCD

Add Promo Code?

I wish to receive marketing & promotional material from SCD

I would like to join the Digital Cash Rebate* rewards program. I agree to the terms and conditions applicable.

By creating an account, you agree to scdlab’s website Terms and Conditions and Privacy Policy*

By creating an account, you agree to scdlab’s website Terms and Conditions and Privacy Policy

Signup

Personal Information

Practice Details