The following is contact information that will be reflected on the Non-Discrimination page of your website. In many instances it will be the same as your normal practice information, however, in some cases it will be more specific. Please provide data for each field; all fields are required by the ADA.
The covered entity may be your practice or your corporation.
The office coordinator is the person in your office who will be contacted by the client via the Non-Discrimination page. This could be the Office Manager, Practice Administrator, Owner of the Practice, etc.
Please go to www.dentalfreeway.com and click on Site Samples, and then your specialty. Review the different designs, looking at layout of content and different features on the site.
Keep in mind that the colors and banner images can be changed on all sites to different scenic ones, people, or even your office. So choose based on overall layout and placement of elements, not colors and banner pictures.
If you can't decide, then enter "PBHS choice" here and we'll choose a design for you. We need your logo and this questionnaire filled out with as much detail as possible in the sections below in order to choose a design.
In case your first choice is already in use by another client in your area, what is your second choice?
Upon receipt of this questionnaire, we will post your new website on a temporary location and send you a link to review it. Please give us a call at this time so we can talk about the design customizations you'd like us to make for you.
We will also send instructions for editing the content. Please let us know if you have any questions or would like a demonstration; we will be happy to schedule some time to show you how it works.
The website can be posted at any time, so please let us know when you're ready. Allow a few days time for final site review and domain transfers to post the site.
I look forward to working with you and your practice!