Sesame Edits Request Form

1

Sesame Edits Request Form

This form is designed to help you easily provide us with detailed information about your website updates, so that we can deliver those changes as quickly as possible. The following pages will walk you through the information that we require, so please be sure to fill out each section as completely as possible.
2
Please note that this form is for website edit requests only!

If you would like to make an addition to an open edit request that you have previously submitted, please call our Member Services team at 866-537-8272 to update your request.

Please be aware that submitting this form will result in billable work at a rate of $100 an hour, with the first hour minimum. This includes any time required for us to clarify your request.

If your request solely consists of an update regarding COVID-19, please use this form instead: COVID-19 Edit Request Form

You can expect your request to be completed 7-10 business days from the time we have all information required to begin.

If you need help with DIY editing, or have any questions, please Go Here instead!
3
Your Name* This field is required.
First Name
Last Name
4
Email Address* This field is required.
example@example.com
5
Doctor or Practice Name* This field is required.
6
Phone Number* This field is required.
Area Code
Phone Number
7
Your Website* This field is required.www.example.com
8
Which page do you want to edit?
Entire Site (Edit applies to all pages)
Home Page
Meet the Staff
Meet the Doctor
Contact Us/Office Location
Before and After Gallery
Office Tour
Other (Please specify later)
9
What would you like us to change on the Entire Site?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
10
Files needed to update the Entire Site.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.5MB
Cancelof
11
What would you like us to change on the Home Page?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
12
Files needed to update the Home Page.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
13
What would you like us to change on the Meet the Staff Page?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
14
Files needed to update the Meet the Staff Page.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
15
What would you like us to change on the Meet the Doctor Page?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
16
Files needed to update the Meet the Doctor Page.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
17
What would you like us to change on the Contact Us/Office Location Page?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
18
Files needed to update the Contact Us/Office Location Page.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
19
What would you like us to change on the Before and After Gallery?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
20
Files needed to update the Before and After Gallery.Please upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
21
What would you like us to change on the Office Tour Page?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
22
Files needed to update the Office Tour PagePlease upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
23
What would you like us to change on another page or pages?Please be as specific as possible. If you need to send us any files, you can do so on the next screen.
24
Files needed to update another page or pagesPlease upload any files we need to complete these changes to the Entire Site. The total size limit for this entire request is 50MB.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
25
That's it!

Please go back and review to ensure that all of the information required to complete this request has been provided, and click Submit below.

If our team has everything we need to begin work on your request, you can expect it to be completed within 7-10 business days.

Please be aware that submitting this form will result in billable work at a rate of $100 an hour, with the first hour minimum. This includes any time required for us to clarify your request.

If you have any additional questions, please don't hesitate to reach us at 866-537-8272 or memberservices@sesamecommunications.com
26
Tags
Todo
In Progress
Done
Should be Empty: