If you are a single location clinic, having admin access will automatically grant you organisation level access.
If you have more than one location, you will need to have organisation level access to make these changes - your account owner can grant you access.
Click on Admin in the right hand menu.
Ensure that you are at the organisation level but selecting "Organisation" in the drop down just below the page title.
Click "Settings" in the Organisation Settings box and then "Tax Rates".
Click the blue plus button.
Complete the name description and % rate.
Select if this tax will apply to services, products or both.
Click "Save".