Your Name*

Practice Name*

Address

City/State/Zip

Email Address*

Phone*

Fax

Website

Which package would you like?
Package A - 2 updates per year and a holiday program ($39 per month/per location)Package B - 4 to 6 updates per year and a holiday program ($49 per month/per location)Purchase Option - $295 to $395 for USB or Network Load Digital Player and $295 for a custom program. (No monthly fees)

What image do you want to project?
Professional StaffHigh End FacilitiesFamily FriendlyCaringNew TechnologyChildren Friendly

Business Hours:

Doctors Names: Please fill-in below.

Which are the primary services/features at your Dental Practice? Please choose all that apply.*
Cosmetic DentistryTake-home WhiteningIn-office WhiteningFamily DentistryChildrens DentistryOrthodonticImplantsCerecAir AbrasianViziLiteLumineersDigital X RaysInvisalignSedation DentistryPeriodonticsEndodonticsPorcelain VeneersTooth Colored FillingsOnlaysInlaysCrownsOther (Please list in below)

What are some of the features or services at your practice that you would like to highlight, and how do they directly benefit your patients? Please fill-in below.

Have you launched any new marketing campaigns? (i.e Limited time specials, promotions, tradeshows, trade associations, etc. Special messages you would like reinforced in your message.) Please fill-in below.

Please list anything at all! (New/updated website, new telephone numbers, new employees, awards, community activities etc. Be creative!) Please fill-in below.

Are there special products or services you offer which your patients may not know about or forgot about? Please fill-in below.

What are some of the questions most frequently asked by your patients? Please fill-in below.

Music type preferred:
Smooth JazzClassicalEasy ListeningLite RockCountryPop

Voice talent preferred:
MaleFemaleBoth Alternating