Deal Summary About the DealSales Person*Which Brand is this for?*- Select An Option -Dental MarketingMed Spa MarketingDonato.ai (Entrepreneur)Link to PandaDoc Contract*If you need help getting this link, please reach out to Shannon.What is the length of the agreement?*Photoshoot Included?*YesNoPhotoshoot Dates If RequestedSetup/Initial Fee*Effective Date*Charge ImmediatelyCharged through StripeAbout the ClientIs this a startup or recently opened office?*YesNoWhat is their open date?*Practice Name*Practice Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Doctor's Name*Legal NameMain Point of Contact Name:*Main Point of Contact Email*Main Point of Contact Phone*Onboarding Point of ContactThe doctor or team member filling out the onboarding form. Same As Main Point of Contact Onboarding Point of Contact Name:*Onboarding Point of Contact Email:*Onboarding Point of Contact Phone:*Specific Date / Time For the Onboarding Call?*YesNoClient Request Date / Time For Onboarding Call*Best Time To Call*- Select An Option -MorningAfternoonEveningAnyBest Days To Call* Monday Tuesday Wednesday Thursday Friday Notes About Point of Contact's ScheduleExamples: On vacation until next week, Only works on Mondays, Only available after 3PM Eastern, Etc. Practice Management System*What Services Did Client Sign Up For* Gold-Startup Plan Platinum-Startup Plan Economy-Startup Plan Digital Plan Direct Mail Plan Combined Plan Full Website Development Specialty Landing Page Logo & Branding Digital Content Production Does their plan include mail?*YesNoMonthly Starting Ad Budget*- Select An Option -$1500 ($50/day)$1200 ($40/day)$900 ($30/day)OtherCustom Daily Ad Budget*Direct Mail Pieces and Price*- Select An Option -2.5K Pieces - $10755K Pieces - $215010K Pieces - $4300Monthly Management Fee Total*This price does not include ad spend and mail pieces.Full Website Development - Price Offered*Specialty Landing Page - Price Offered*Logo & Branding - Price Offered*Digital Content Production - Price Offered*Multiple Locations?*YesNoWhich location is this deal for?*Is this client affiliated with other partnerships? If so, please choose options below. DW Membership DW Practice Group Delivering Wow Smiles at Sea Breakaway Seminars Client's Pain PointsWhy did they sign up with us? What are some reasons why the client did not like their previous marketing company?Did the client specify any expectations for investing in a marketing company?Ex: Dental implant focused, emergency focused, wants to rank higher on Google, etc.Digital QuestionsDigital timeframe and expectations set to the client during sales.How many days does the client expect to have the campaigns go live?Did the client get a walkthrough of our Dashboard?YesNoContract NegotiationAnything offered for FREE or discounted?* Nothing was offered for free or discounted Free Discounted What services were offered for FREE and why?*What services were discounted and why?*Any other conditions agreed upon outside of the contract?*YesNo, there were no other conditions agreed upon.Other Conditions*Mail QuestionsDirect Mail timeframe and expectations set to the client during sales.*What month does the client expect mail to drop?Submitted ByYour Name* First Last Your Email*