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Shane's Tags Sign Up
Interested in getting a display? We are here help!
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1
Let's start with your full name
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First Name
Last Name
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2
What email address can we reach you at?
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3
What is your phone number?
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What type of business is this for?
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5
What is your job title?
Ex: Owner, Manger, Secretary, Etc...
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6
Which type of display are you interested in getting for your business?
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Basic Display ($150)
Premium Display ($180)
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7
What size display do you want?
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4x6"
5x7"
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8
What size display do you want?
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4x6"
5x7"
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9
How many displays do you want?
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$30 Per Extra Display (One Location)
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10
How many displays do you want?
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$35 Per Extra Display (One Location)
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11
What monthly plan do you want?
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Starter Plan ($35/Monthly)
Premium Plan ($50 Monthly)
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12
Please choose which features you would like to add.
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Wi-Fi
Menu
About Page
Review Page
Social Media
Contact
Help/Support
Request Appointment
Other
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13
Please choose which features you would like to add.
*
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HIPAA Compliance COVID-19 form (Does require password to open the PDF submission every time)
NON HIPAA Compliance COVID-19 form (Doesn't require password to open the PDF submission every time)
HIPPA Compliance Patient Form (Does require password to open the PDF submission every time)
NON HIPPA Compliance Patient Form (Doesn't require password to open the PDF submission every time)
Request Appointment
Wi-Fi
About Page
Review Page
Social Media
Contact
Help/Support
Other
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14
Please sign below to confirm that you want the options selected
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Clear
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15
Todays Date
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Date
Month
Day
Year
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