Fetchit does not need to be installed on the server for a cloud PMS, unless the clinic uses a CallerID Vertex box, in which case follow the CallerID box installation as well.
On every workstation
Run the Fetchit installer as administrator and select Client.

Complete the installation and launch Fetchit.
The installer adds Fetchit to the shell:common startup folder, so it launches at startup for any logged-in user. It will not launch at startup if the shortcut is set to run as administrator and the first user logged in at boot is not an administrator.
Fetchit appears in the Windows task bar tray.

Right click it and open Setup, then enter the connection secret from the client's Orion page.

Select the full connection secret in Orion with Ctrl+A. A partial copy throws an error when you submit it.
Set the popup style to ezyVet, which is cosmetic and down to preference, and select the clinic's PMS from the dropdown. Leave the rest as it is and click Submit.
Then the browser extension
A cloud PMS lives in the browser, so the desktop application needs the Fetchit browser extension to open patient records. Install and configure it on every workstation before you call the install done.
Verifying
Right click the tray icon and open History.

There should be entries here if the clinic already had a phone system and this was not a first-time install.
To check the connection secret took, press Test Broadcast in Orion. A red Broadcast 0 0000-0000 popup appears on screen. If it does not, the connection secret is wrong: enter it again, save, and retry.
Then call the clinic you have just installed for. You should see a popup for your own call, which proves the desktop application works and that the phone worker, service or CallerID box is hearing calls.
Clicking the Fetchit button on that popup should open the browser at the customer's PMS record. If it does not, check the browser extension is installed and configured properly. There is more you can do from the broadcast screen in Testing with Broadcast.