MINDALA · PARTNERS

Partnership & supervision request

Tell us about your work and how you would like to collaborate. No sign-in is needed to send this application.

01Send your application
02Mindala reviews & approves
03Sign in & start requests

1. Partner details

For clinics, NGOs, churches, community groups, companies and independent professionals.

Partner / professional name * Partner type * City / location Website (optional)

2. Your contact details

Full name * Role / position * Email for future Google sign-in *Use an email you can sign in with through Google after approval. Contact phone *

Affiliation & representation

Enter your own organisation above. If independent, choose Independent and enter your professional name.

Your branch (if any) Your centre (if any) Applying as

3. Proposed collaboration

What would you like to request? Choose one or more.

Brief introduction & reason for partnership * Professional qualifications, where relevant (optional)

Use this form for partnership information only. Please do not include patient names, case details or medical records. Case referrals come later through the approved workspace.

I am authorised to submit this request and agree that Mindala may use these details to review it and contact me.

Submitting does not grant access. Mindala reviews your partnership and named contact first; professional tools require separate approval.

Requested supervision