Pricing Form Page

Practice Name(Required)

Name(Required)

First Last

Email(Required)

Phone(Required)

How did you hear about us?(Required)

Type of Practice(Required)

Practice Management System(Required)

If Other, Please Specify:(Required)

X-Ray / Imaging System(Required)

If Other, Please Specify:(Required)

CBCT Imaging System(Required)

If Other, Please Specify:(Required)

How Many Locations Do You Have?(Required)

Please enter a number greater than or equal to 1.

How Many Servers Do You Have?(Required)

Please enter a number greater than or equal to 1.

How Many Workstation Computers Do You Have?(Required)

Please enter a number greater than or equal to 1.

Length of Agreement(Required)

Month-to-Month Agreement (Add 4% to all prices)

1 Year Agreement (Discount 5% from all prices)

2 Year Agreement (Discount 10% from all prices)

3 Year Agreement (Discount 15% from all prices)

Do You Need Managed Firewall Protection? ($75 per month)(Required)

Yes

No

Do You Need Microsoft Office 365? ($15 / user per month)(Required)

Yes

No

Number of Microsoft Office 365 Users ($15 / user per month)(Required)

Please enter a number greater than or equal to 0.

Do You Need Saturday and / or Sunday Support? ($100 per month)(Required)

Yes

No

Need Additional 100GB units of Cloud Storage? ($50 / unit)(Required)

Please enter a number greater than or equal to 0.

Pricing Calculator