Get the e-Minder Plugin - Event Special We'll have you up-and-running in no time. Only $75 per month – Event Special (per practice location + implementation fee) Just set it and forget it. No more per-message fees. No more having to replenish credits. Ready to get started? Let's do this! Client InformationOrganization Name *Name of your practice or organization.Contact Person Name of the person whom the invoices will be going to be sent to. Organization Address *Address of the main location if client has more than 1 clinical address.Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone *Email *Email address of the contact person whom the invoices will be sent to. Plugins / Modules / Services *Check all plugins you want added.E-Minder Unlimited (text and email reminders)Please tell us which locations you'd like this implemented. You can list specific locations, or tell us to implement for all your locations.How many locations do you want activated? *You may have 50 locations, but perhaps you only want 5 locations using this plugin. Appointment Reminder Response Email Address All appointment reminder messages state clearly that the emails are automated and not to reply, however many patients still reply to them with cancellations and changes. The system can forward all responses to an email address of your choosing. This way if patients respond to the emails you will receive them. Consequently however, you should be aware that you will also receive all bounced emails. This can be helpful to know when you have bad email addresses so you can correct them. However, it can result in a large number of emails coming into your inbox until you correct the bad addresses (especially when first starting out). So be prepared for a deluge of bounced emails for at least the first couple weeks until you get the addresses straightened out and corrected. Please list the email addresses that you want to receive replies. You can list more than one. Please tell us anything here. Subscription *Would you like to commit annually or go month-to-month?Annually - Bill me $900 per location annually. (no implementation fee!)Monthly - Bill me $75 (per location) monthly and charge me $500 for the implementation Email Delivery DisclaimerPlease read and understand the following. *Message Reliability and Delivery Disclaimer. Email and Text messaging (the Messages) by nature are not fully reliable methods of sending Messages as they are a 'non-confirming' delivery protocol. This means that there is no guarantee that any email or text sent from our system will be delivered to its intended recipients. Successful Message delivery requires acceptance and or transfer by the recipient server or carrier, which may be prevented due to a variety of reasons, to include but not limited to carrier restriction(s) or overly-aggressive spam filters, IP blocking and malware software that may falsely flag the incoming email as malicious. The scope of our service is limited only to successfully send all Messages from our system, with no guarantee that the Messages will reach their intended recipients, and as such, no refunds shall be provided for this service, in whole or in part. We also recommend that you add a disclaimer to your no-show/cancellation policy. Yes, I understand. AuthorizationTerms and Conditions. *Yes, I agree to the terms and conditions listed above.Electronic Signature *Please enter your full name above. This is considered your legal consent and endorsement and will be accepted as your written signature. VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - <strong>please leave it blank</strong>:
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