Marketing Request Form

1
Name
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Facility* This field is required.
Beckett Springs
Brentwood Springs
Carrollton Springs
Collin Springs
Columbus Springs
Columbus Springs East
Copper Springs
Copper Springs East
Cottonwood Springs
Denver Springs
El Dorado Springs
Help for Heroes
Highland Springs
Lifepoint Behavioral Health (HSC)
Mercy Health BH
Mesa Springs
Oakwood Springs
Rainier Springs
Rock Springs
Sycamore Springs
Tampa General BH
Triangle Springs
Valley Springs
WellBridge Fort Worth
Westpark Springs
Woodland Springs
Other
4
Has this request received the appropriate internal approval? * This field is required.Please obtain approval from Alex Brasher prior to submission.
YESNO
5
Request Type* This field is required.
Brochure
Card/Mailer
Update Existing Print Collateral
Flyer
Print Ad
Rack Card
Social Post
Business Card - Special Order (Check Vivid First for an Existing Template)
Constant Contact Email Template
Vinyl Banner/Poster
Other
6
In-Hand Date Needed* This field is required.
Date
Month
Day
Year
7
Flyer
Please Select
Please Select
Yes
No
Do you need this to be printed?
Target Audience
Objective / Message / Call to Action
8
Rack Card
Target Audience
Objective / Message / Call to Action
9
Card/Mailer
What type of card do you want?
Target Audience
Objective / Message / Call to Action
10
Vinyl Banner/Poster
Width (inches)
Height (inches)
Objective / Message / Call to Action
11
Brochure* This field is required.Please describe the purpose of the brochure, including audience, messaging, etc. A team member may schedule a follow-up meeting to review your objectives and outline a content strategy. Please give as much detail as you can so that we can complete the piece in a timely fashion.
12
Update Existing Print Collateral* This field is required.Please include the Item ID# found in the lower right corner of the existing document and SPECIFIC DETAILS of all update(s) needed.
13
Social Post
Please Select
Facebook
LinkedIN
Select platform(s)
Target Audience
Objective / Message / Call to Action
14
Print Ad
Width
Height
Please Select
Please Select
B & W
Color
Color
Target Audience
Ad Placement (Directory, magazine, etc.)
Objective / Message / Call to Action
15
Constant Contact Email Template* This field is required.Please provide as much detail as possible. You can upload your CEU schedule or other supporting files on the next page.
16
Business Card - Special Order (Check Vivid First for Existing Template)* This field is required.Provide business card details, as well as the "Ship To" address if different than business card address.
Huge
Large
Normal
Small
Ok
Ok
17
Other* This field is required.Please provide as much detail as possible. You will have the option to upload supporting files on the next page.
18
Print QuantityIf applicable
19
File UploadPlease include any supporting documentation needed to complete your request.
Drag and drop files here
Select files to upload
Cancelof
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