Download Trial Version
KC International SoftCom Messaging Dental Intra Office CommunicationSoftware Solution

3Dworld.gif (53133 bytes)KC INTERNATIONAL, Inc.
Fields marked with are required.

Use Proper Formatting.  Examples are to the right of each field.

Name
First Name: (John)
Last Name: (Smith)
Suffix: (DDS, DMD, MD)
Full name: (John Smith)
Title: (Vice President, Owner)
Work
Company: (New Dental, Inc.)
Email: *See note below!
Business address
Street address: (1900 Sunset Blvd.)
(Suite A)
City: (Cameron Park)
State (or region/province): (CA)
Postal code: (93566)
Country: (USA)
Business communication
Phone number: 800-555-0111
Fax number: 800-555-0112
Web page address: (http://www.newstarss.com)
Misc.
Mobile phone number: 530-899-1214

How Did You Hear About KC International?
Use your Ctrl key to select multiple items if needed.

If you selected "Web Search Engine"
Which Engine? Only if you selected Web Search Engine above.

If a Web Search Engine was used what keywords did you use to find our site?

If you selected Friend or Other please supply the source or the name
of your friend so they can participate in our Referral Program
 Only if you selected Friend or Other above.

What Practice Management Software do you currently use?

Additional Comments or Questions

Send the Install Unlock Code to my email address: *
*You MUST provide a valid email address because the install program is password protected.
This form will automatically email the provided address with the password to unlock the install
program. If you have problems call 530-676-4078.

@aol.com, @msn.com, and @hotmail.com addresses might take some time to receive the unlock code email from our servers.  99% of the time it only takes minutes to receive. AOL Users MUST check their SPAM folders for this email. 

Privacy note: This Information will NOT be distributed or sold. It is for KCI internal use only so we can better serve you and our referrals.

Press to receive the Install Unlock Code via the email address you entered above.
After pressing SEND it might take up to 1 minute to load the next screen.

 
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