Let’s Get Started!

Now that you are ready to start your website, please take a moment and fill out the information below.  This information will go on your website, so take your time and be sure to fill out everything to the best of your ability.

Once finished, click the ‘Create My Site’ button and we will receive your information and get started on your website immediately.

For custom images and patient forms we will follow up with you by phone or email to obtain those files once the website creation process has begun.

Your Name

Your Email

Practice's Phone Number

Practice's Full Address

Practice's Hours, Please List Per Day If Hours Are Specific

Practice's Specialization(s) and/or Service(s)

Practice's domain name (example: "www.JohnSmithMD.com" or "www.MichiganMedicine.com")
(list your domain name ideas here; if you already have a domain, list it here; if you are unsure of the answer, type "not sure")

Select a Template (To see our layouts, Click Here - Link opens in new window)

Home Page Text - Give us some welcome text to put on the primary landing page of your website.

About Page Text - Tell us about your practice

Additional Comments - Is there anything else you want us to be aware of, or other information you want to be prominent on your website?