Practice Information Success is in the Details Practice DetailsPlease enable JavaScript in your browser to complete this form.Practice Information - Step 1 of 5We're almost at the finish line! In this final section, we'll gather the practical details about your practice. These specifics will enable us to tailor your website to work seamlessly with your day-to-day operations, ensuring a smooth experience for both you and your patients. Let's dive in and complete these last essential steps.Exact Practice Name: *Please list the practice name as it appears on signage and storefront.Primary Website Domain URL: *Please list your primary website domain (www.YourPractice.com).Do you have an existing website at that domain? *YesNoPlease include any other URL's that your practice owns:Please list any other domains or websites that YOU OWN that could possibly be associated with the practice (such as: www.IndivdualDoctorsName.com).Primary Office Email Address *This is generally the email address used for patient correspondence.Main Office Telephone Number: *This would be the public facing (local) telephone number of your practice.Exact Practice Address (Please Include Suite Numbers if Applicable): *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhen Did Your Practice Open (Month & Year)? *Open Business Hours: *Please list the hours your business is open.Languages Spoken Fluently By The Receptionist(s) Answering Your Phones *Please list any languages spoken at the office.NextDoctor(s) Full Names: *Please list all doctors practicing at this location separated by commas.What do your patients call the doctors?Example: Dr. Firstname or Dr. Lastname, Dr. NicknameHow Long Have The Doctors Been in Practice: *Please list how long each doctor has been practicing.Please list any dental associations you belong to (AACD, ADA, State Level Associations, etc.):Has the practice or doctors won any awards? If so, please list them all here.This could be things like "People's Choice" or "Voted Top Dentist in State by..."Please provide a patient testimonial you are proud of. Helpful Hint: Did this interaction change the patient's life? OR what do you think your patients love about you/your practice?NextPayment Methods Accepted (Please select all that apply): *CashCheckVisaMastercardAmerican ExpressDiscoverIn-Office Financing OptionsThird Party Financing OptionsPlease select all applicable payment methods.If You Offer Financing Options, Please Explain Your Available Options Here:Please provide as much detail on 3rd party vendors or in office financing options here.Major Insurances Accepted (if too many to list, you can send at a later date):Do you offer any patient specials?Examples: New Patient Special, % Off Services, Free Whitening, Service-Member Discount, etcWhat is your STARTING price of Veneers?Note: We won't include specific pricing on your website or ads (unless you ask us to). However, we will sometimes include a starting range of pricing. For example, our porcelain veneers start at only $900!What is your STARTING price of Dental Implants?Note: We won't include specific pricing on your website or ads (unless you ask us to). However, we will sometimes include a starting range of pricing. For example: Dental implant pricing starts at only $1400.What is your STARTING price of Invisalign?Note: We won't include exact pricing on your website or ads (unless you ask us to). However, we will sometimes include a starting range of pricing. For example: Invisalign treatment starts at only $4500!Are there any other services you offer that have an attractive starting price? If so list them and their starting price:NextPlease select all services offered at your practice: *General DentistryCosmetic DentistryChildren's DentistrySedation DentistryLaser Dentistry3D X-RaysBracesBone GraftingCEREC Same Day CrownsClear Aligners / InvisalignDental BondingDental BridgesDental CrownsDental FillingsDental ImplantsDental SealantsDenturesExtractionsGum Disease Treatment/Periodontal TherapyImplant Supported DenturesInlays & OnlaysLumineersMercury Free FillingsMini Dental ImplantsOral Cancer ScreeningsOral/Maxillofacial SurgeryOrthodonticsPeriodonticsProsthodonticsPorcelain VeneersRoot Canal TherapySix Month SmilesSleep ApneaTeeth WhiteningTMD/TMJ TherapyPlease select all that apply.Please include any services you offer not listed above:What specific brands does your office use? (e.g. Zoom Whitening, Opalescence, Clear Correct, Invisalign, etc.)Please help us showcase which brands you use that might be recognizable to patients.What specific technology do you use in office? (e.g. Sirona Same Day Crowns, iTero, etc.)Please help us showcase any technology that patients would be interested in learning about.NextAdditional Google Business Profile Info (please check any that apply):Wheelchair Accessible EntranceWheelchair Accessible ElevatorWheelchair Accessible RestroomWheelchair Accessible SeatingRestroomsUnisex RestroomParking LotStreet ParkingValet ParkingFree WifiWoman-LedVeteran-LedOffer Military DiscountLGBTQ+ FriendlyOffers Online CarePlease check any/all that apply.Do you use a third party appointment/communication software such as:Solution ReachRevenue WellLighthouse 360Zoc DocDemand ForceOtherIf other, please list below.Please list any other specific office software you use at your practice:Do You Use Any Microsoft Outlook Products for Email?Microsoft OutlookMicrosoft Outlook 365Please let us know if you use Microsoft Outlook for office emails as we will need to update some settings within your Outlook.Are You Currently Marketing for New Patients? *Please select an answerYes I am currently marketing for new patientsNo, but I am interested in bringing in new patientsNo, I don't need new patients right nowWhat types of marketing are you doing for new patients currently?Ready to grow? Which marketing strategies would you like to learn about?Google Ads Pay Per ClickYouTube & Video AdvertisingFacebook & Instagram AdvertisingEmail Marketing + FunnelsI'm Open to AnythingPlease check all that applyNumbersNumbersWebsiteSubmit