Company Name Trading Name (if different from company name) Main Contact Person Telephone Contact Emergency Contact Public Email Address (for callers) Internal Email Address (for Clinic Connect admin) Website Address Which email address shall we send your messages to? Would you like us to transfer calls to you? Yes No Would you like a personalised out of hours voicemail? - Select option - Yes No Emailed directly to you (as a recorded mp3 file)? Emailed as a transcribed message (costs apply)? How shall we handle sales calls? - Select option - Take a message Ask them to email you Don’t notify me Names of your staff who we will be dealing with? When would you like to start the service? Diary URL Diary Log In Credentials Would you like us to take any medical insurance information from the caller Do all treatments/services require an initial consultation What is your cancellation policy? If more than one clinician does everyone in your team offer the same treatments/services? We will send an SMS or email for appointments booked, cancelled, rescheduled or any queries to the relevant staff member via their preferred contact method unless otherwise directed. How do patients make payment, is this at the appointment? Do you accept cards and cash? Are there any covid policies and procedures in place? Do you offer online appointments ? I understand that the allocated internal number can only be used for divert purposes and cannot be advertised, promoted or published.