B2B Medical Customer Registration Form
Simplify onboarding for healthcare organizations, clinics, distributors, and other business customers with this B2B registration form template. Collect company and contact details, billing and delivery addresses, accounts-payable contacts, customer categories, and product interests in five short steps. Conditional sections reduce repeated address entry. Customize the options and connect submissions to your CRM, ERP, Airtable, or another workflow system.
This template is inspired by a customer story from WILAmed GmbH, a medical device manufacturer that uses Plumsail Forms to collect customer information.
Structure and logic of the form
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The form is divided into five steps using the Wizard container. Company, contact, address, business, and signature details are grouped into short sections that are easy to complete on a desktop or tablet.
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When a user selects Billing address is the same as company address or Delivery address is the same as company address, the corresponding address section is hidden. When a separate accounts contact is needed, an additional contact section appears. This is done with conditional rules in the Hide property of Grid containers.
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The Business email fields accept only data matching a specified pattern. Choose from predefined patterns or create a custom pattern to validate customer information.
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Product groups are collected using a Multiple Choice field, allowing customers to select several areas of interest.
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The authorized person can confirm the registration with an electronic signature.