Partner Onboarding Form - Chiro Boost Program™
Please complete our Partner Onboarding Form in full, so that our team can build your campaign.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Practice Name *
Practice Website URL *
Office Phone Number *
Staff Members' Names
Personal Cell Phone Number (Emergencies Only) *
Best Email Address to reach you (Submit 1 Only) *
Location (Full Address) *
Address, City, State & Zip Code
Which city/area should we call out in the ad? *
E.g. "Hey San Diego Residents..."
What emails(s) would you like to use to receive lead notifications? *
Besides your email, we highly suggest including the email(s) that your Chiropractic Assistant(s) will be using. You can type in multiple emails separated by a comma.
What emails(s) would you like to use to access your dedicated Google Drive? *
Besides your email, we highly suggest including the email(s) that your Chiropractic Assistant(s) will be using to access your dedicated Google Drive. You can type in multiple emails separated by a comma
What phone number(s) would you like to use to receive lead notifications? *
Besides your phone number, we highly suggest including the phone numbers(s) that your Chiropractic Assistant(s) will be using so that you and your staff can be notified as soon as we generate a new lead. This phone numbers need to be able to receive text messages. You can type in multiple phone numbers separated by a comma.
What phone number would you like to use to receive incoming calls from leads? *
Ideally, this would be your office main phone number unless you want to receive incoming calls from leads somewhere else.
Who helped you with this process? *
How did you find out about Compai Media's Chiro Boost Program™? (If you're a referral, please write who referred you to us on the "other" option)
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Compai Media. Report Abuse
Google Forms