Whale Mail Onboarding Form 1 About Your Practice2 Highlight Your Provider3 Branding & Marketing4 Confirmation Welcome Onboard! Please fill out this onboarding form as accurately as possible. This form will provide us with the information we need to build your campaigns. Complete one form for each of your locations. Tell us about your practice Name of Practice*Main Practice Phone Number*Website*How many locations do you have?12345678910More than 10Please complete one form for each of your locations. Is this your last location?If you have completed a form for each of your locations, select yes. Yes, I have completed a form for each of my locations. No, I still have an additional location after this one. Indicate your main locationPractice Address*Suite NumberCity*State*ZIP Code*What is a landmark close to your location?*(i.e., We are across the street from Macy's, we are by IKEA)What areas would you like to mail to?*Select the best routes according to your expertise! (Recommended)Select the best routes, but exclude these ZIP codes.I want to target my own ZIP codes. (Max. 2)Pick routes from this ZIP code:*Pick routes from this ZIP code:Exclude routes from this ZIP code:*How would you describe the dental practice?*New Construction / New PracticeAcquisitionWell-Established PracticeNew Location for a Well-Established PracticeWhat is the estimated opening date?*Tell us a little bit more, how recent was the acquisition?*When did you move?*What month and year did the practice open?*Select the option that applies to you.*Closed capacity - My practice schedule is consistently full and booked out a few weeks in advance. I have minimal to moderate open capacity.Open capacity - My practice schedule is booked consistently 1-2 days in advance with a need to fill the large open capacity.Would you like to assign a direct mail point of contact for your practice?*YesNo, I (the Doctor) will be the point of contactPoint of Contact Name*Point of Contact Phone Number*Point of Contact Email* Your Name*Your Email*Best phone number to reach you?* Which provider would you like to feature/highlight on your mailer? Max. 2First Name*Last Name*Suffix (i.e., DDS, DMD, MAGD)*Provider's BioUpload Provider's Bio Drop files here or First NameLast NameSuffix (i.e., DDS, DMD, MAGD)Provider #2’s BioUpload Provider #2’s Bio Drop files here or Tell us about your branding and marketingDo you have a logo?*YesNoUpload your high-resolution logo fileHigh resolution file of your logo. The file should be in .ai, .eps or .indd. Please also include a .jpg version for digital purposes. Please make sure all images are 300DPI. Are you happy with your logo/branding?YesNoDo you have high-resolution/professional photos?*For high-converting campaigns, it is recommended to have a professional photo shoot at the practice.YesNoWhat is your main message or positioning? Provide three areas of focus.*(i.e., convenience, financing options, latest technology, late appointments, weekend appointments, spa-like feeling, etc.)Unique marketable attributes, amenities or services you have in your office. Add any that are not listed.* Family Scheduling Financing Options Beverage Bar Children's Play Area Extended Hours Video Games Netflix Wireless Headphones Spa Services Blankets and Pillows Massage Chairs Flat-Screen TVs in Patient Rooms Music Saturday Appointments Warm, scented towels Free parking Same-Day Emergency Appointments Other amenities/services you provide: New Patient Call DriversThese call drivers are intended to incentivize new patients to come to your office. Min 3.Adult's Complete Checkup*We recommend starting at $69, including X-rays, exam and basic cleaning. Please give us a price point that you feel comfortable with. Indicate what is included, restrictions and ADA codes.Price with promotionReg. priceWhat's includedADA CodesRestrictionsComplimentary Consultation*Please indicate what is included, restrictions and ADA codes. Reg. priceWhat's includedADA CodesRestrictionsFree Whitening Treatment*Please indicate what is included, restrictions and ADA codes. Reg. priceWhat's includedADA CodesRestrictionsChildren's Complete CheckupWe recommend starting at $49 including exam, X-rays, fluoride application and basic cleaning. Please give us a price point that you feel comfortable with. Indicate what is included, restrictions and ADA codes. Price with promotionReg. priceWhat's includedADA CodesRestrictionsEmergency ExamWe recommend starting at $39, including a limited exam. Please give us a price point that you feel comfortable with. Indicate what is included, restrictions and ADA codes. Price with promotionReg. priceWhat's includedADA CodesRestrictions$ ____ OFF a Specialty TreatmentWe recommend starting at $100 Off. Please specify which treatment this would be off of and the price point that you feel comfortable with. Indicate what is included, restrictions and ADA codes.TreatmentAmount OffWhat's includedADA CodesRestrictionsOtherList your custom call driver and indicate what is included, restrictions and ADA codes.Do you have an In-House Discount Plan or Dental Savers Plan?*For a Value Message Postcard, we may highlight a chart like the examples below. YesNoPlease upload your chart for your In-House Discount Plan or Dental Savers Plan Drop files here or ConfirmationPlease review your information and then click submit.{all_fields}Submitted By* First Last Information Accuracy* I confirm that the information above is accurate and free of errors. Your Email*A copy of this form will be emailed to you for your records.
