What is the name of your business as you want it to appear online?*

(e.g., Lifted Logic vs. Lifted Logic Farms, LLC)

What is the domain (URL) of your website?*

Who is your Lifted Logic project manager?*

Adam Testerman

Andrew Reed

Emma Levine

Kevin Nash

Hailey Matovic

Macyann Crawford

Meredithe Hill

Samantha Nay

Todd Smidt

Who will be your main point of contact?

Full Name & Title*

Phone*

Email*

Who on your team should have access to the backend of the Treatment Builder Tool (view entires, modify treatments/concerns, etc.)?*

First Name

Last Name

Email

Once a user submits their Treatment Builder form, who should be notified via email? (Please enter all email addresses below):*

Do you currently have a Google Analytics account?*

Yes

No

Have you shared admin access with GA4@liftedlogic.com

Yes

No

In order for us to connect your new Treatment Builder with your existing Google Analytics, we'll need you to share access with us. Please follow the below instructions:
Sign in to Google Analytics (note: Analytics accounts can ONLY be attached to Gmail accounts)
Click "Admin" at the bottom of the left-menu
In the "View" Column on the very right, select "View Access Management"
In the "View access management" list, click "+," and then "Add Users"
Enter GA4@liftedlogic.com and hit the "enter" key
Check the "Notify new users by email"
Under "Direct roles and data restrictions" select "Administrator"
Click the blue "Add" button in the top right corner

Logo & Branding

Upload your Logo Files Here (vector file if possible: .ai/.eps/.svg):

If you don't have a vector file, we may not be able to put the logo on the banner since it is being printed at such a large size. Please ask your project manager if you'd like a quote for us to create one for you!

No file selectedBrowse

Drop files here

Max. file size: 50 MB.

What font is used in your Logo?*

Optional: Upload a provider headshot

This image will be featured on the first page of your treatment builder.

No file selectedBrowse

Drop files here

Max. file size: 50 MB.

Do you currently have any brand standards or guidelines you'd like to upload?*

Yes

No

Upload them here:

No file selectedBrowseMax. file size: 50 MB.

If not, please let us know if you have any preferences with respect to colors and fonts:

Treatments*

Please enter all the treatments you currently offer that you'd like to feature in your treatment builder (one treatment per line).
Select "Add" to add each new treatment.

Last but not least....

Let us know where we should mail your in-office Treatment Builder banner*

Street Address Address Line 2 City State ZIP Code