Practice Onboarding | Platinum Membership - Engage Technologies Group

Primary Practice Contact

We want to insure your staff receives the best support from our team while engaging with your patients. Please provide the primary contact information below. This individual will receive all support and training related material.

Primary Contact Name(Required)

First Last

Primary Contact Mobile(Required)

Primary Contact Email

Practice Information

The information you enter in the following sections will be public facing. Before submitting, you will be asked to verify all of your information.

Practice Name(Required)

Practice Address(Required)

Street Address Address Line 2 City State ZIP Code

Patient Quick Access Links

The information entered in this section will be displayed at the bottom of your portal.

Practice Phone(Required)

Practice Email(Required)

Practice URL(Required)

We have prefilled the https:// for you already, just add your primary main domain after it in this field. The final result should look like this example: (https://engagetg.com)

Upload Practice Logo

Please make sure the file is saved either as a png, jpg, pdf or eps.

Practice Logo(Required)

Accepted file types: png, eps, jpg, jpeg, pdf, svg, zip, Max. file size: 100 MB.

Does your practice use a management software?(Required)

Yes

Which Practice Management System does your practice use?(Required)

A medical practice management system is a type of healthcare software that manages the day-to-day operations of a clinic, such as appointment scheduling, billing and other administrative tasks.

Information and artwork approval(Required)

Before selecting SUBMIT please check here to verify that all your information is entered correctly. Submitting the wrong information or incorrect image file type, may result in production delays.

This field is for validation purposes and should be left unchanged.