Portals
Healthtek Portals
Features List
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Content Creation
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Portals
Healthtek Portals
Features List
Request a Demo
+Health
Content Creation
Health Tokens
Contact Us
Login
Please enable JavaScript in your browser to complete this form.
1
Customer Information
2
Plan Information
3
Payment
Primary Contact Information
Company representative's name:
*
First
Last
How would you like to be contacted?
*
Selection ...
Email
Email + Phone
Layout
Best contact email address:
*
Best contact phone number:
Company Information
Company name:
*
Company website / URL:
*
Main company Employee Assistance Program (EAP) provider:
*
Select one ...
Lifeworks, Inc.
Optum, Inc. (Global)
Optum, Inc. (USA)
WayForward/Dario Inc.
None
Other
Do you have more than one provider?
No
Yes
Enter the name of any additional EAP providers here:
Next
Select a portal theme you would like:
Apple
Banana
..
?
What Portal plan are you interested in?
Select one ...
Basic
Plus
Enterprise
Plan Customization Options
Upload your company logo:
Click or drag a file to this area to upload.
..
?
Which 'Engagement Section' web apps would you like visible?
Breathe Web App
Quotes O-Day Web App
Music Web App
Poster Web App
..
?
How many custom spotlight banners would you like?
None
1
2
3
..
?
Layout
Spotlight Title #1
..
One short sentence.
Summary text #1
..
Two short sentences.
Upload source image #1
Click or drag a file to this area to upload.
'Learn more' website link #1
Spotlight Title #2
..
One short sentence.
Summary text #2
..
Two short sentences.
Upload source image #2
Click or drag a file to this area to upload.
'Learn more' website link #2
Spotlight Title #3
..
One short sentence.
Summary text #3
..
Two short sentences.
Upload source image #3
Click or drag a file to this area to upload.
'Learn more' website link #3
Would you like to add any icon tray links?
No
Yes (up to 3)
Yes (up to 6)
..
?
Icons 1 - 3
Link name
Website / URL
Link name 2 (Optional)
Website / URL 2 (Optional)
Link name 3 (Optional)
Website / URL 3 (Optional)
Icons 4 - 6
Link name 4 (Optional)
Website / URL 4 (Optional)
Link name 5 (Optional)
Website / URL 5 (Optional)
Link name 6 (Optional)
Website / URL 6 (Optional)
Do you have a special domain name you would like to use for your portal?
No
Yes
..
?
Share your Domain name / URL here:
Would you like a custom alert message at launch?
No
Yes
..
?
Enter your alert message here:
Is your company interested in custom articles and/or videos?
No
Yes
..
?
Should a 'Manager's Section' be added to your portal?
No
Yes
..
?
Enterprise Concierge Service
Thank you for selecting the Enterprise plan option. This plan option offers a concierge service option for us to call you and complete this form's feature details with you over a video call.
Your Healthtek team member is Yon Hardisty and you are invited to call him during business day hours (M-F, 9am to 5pm PT) or email at anytime and Yon will get in touch to find a time to connect.
You can reach Yon here:
• Phone: (510) 398 - 3753
• Email:
yhardisty@healthtekcreative.com
You do not need to complete this form at this point. However, if you would like to proceed to the final payment step and complete it now, you are more than welcome. Otherwise, Mr. Hardisty will pick up where this form left off when you connect.
Previous
Next
One Last Step!
Thank you for working with us in the setup of your new Healthtek Portal account!
Please confirm the type of plan you would like:
*
Basic - Monthly Subscription - $ 200.00
Plus - Monthly Subscription - $ 300.00
Secure Credit Card Payments By Stripe
*
Card
Name on Card
Complete Your Order
?
Have Any
Questions
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