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Practice Details Submission
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Staff Bios Submission
Practice Details Submission
Practice Details Submission Form
Step
1
of
10
10%
Welcome
This form has been built to capture the key details from your dental practice and to ensure a smooth transition into the new platform. The form should take
less than 15 minutes
to complete, however, there is the option to
save your progress
and return later should you need to. We will ask for details abour your practice, logos, colours, content, socials, website, treatments and providers.
With that said, grab a drink and a snack, sit back and let’s get started. Press
NEXT
to move to step 2 when ready.
Step 2: Primary Contact Details
Please provide the contact details of the best person to speak to, should we have questions regarding the information you provide.
Primary Contact Name
(Required)
Primary Contact Email
(Required)
Practice Contact Phone
Step 3: Business Details
Please provide some key details regarding your business, website and branding.
Business Name
(Required)
Website Link
(Required)
Year Practice was Established
(Required)
Business Logos (Good quality, png format with no background)
Please upload all version of your logo that you have on hand. This could include coloured and full white/reversed versions of your logo in portrait, square and landscape formats.
Drop files here or
Select files
Accepted file types: jpg, png, svg, pdf, gif, Max. file size: 20 MB, Max. files: 15.
Practice Colours: Primary and Secondary
(Required)
I know my business branding colours and would like to select them
I would like Bupa to select our primary and secondary colours based on our logo and website
Business Primary Colour # (Hex code)
(Required)
Click here to choose your colour match. If you cannot determine your primary colour, we will select it for you based on your logo and current website.
Color
Pick color
Business Primary Colour # (Hex code)
(Required)
Click here to choose your colour match. If you cannot determine your secondary colours, we will select it for you based on your logo and current website
Color
Pick color
Step 4: Business Accounts
Please provide more details regarding key accounts relating to your business.
Do you own and manage your DNS (Domain URL)
(Required)
Yes
No
Unsure
Do you know who manages your DNS (Domain URL)
(Required)
Yes
No
Email of the DNS manager/agency
(Required)
If you do not manage your DNS (Domain URL), or do not know who manages your DNS, please contact us to track down the ownership and management of your business domain.
Do you own and manage your Google My Business listing
(Required)
Yes
No
Unsure
Do you know who does manage your Google business listing?
(Required)
Yes
No
Email address associated with Google My Business
(Required)
For details on how to find and claim your Google my business listing, visit here: https://support.google.com/business/answer/2911778
Do you own and manage your Google Analytics
(Required)
Yes
No
Unsure
Do you know who does manage your Google Analytics
(Required)
Yes
No
Google Analytics Tracking Code
Email address associated with GA account
(Required)
If you do not manage your Google Analytics account, or do not know if you have an account configured for your business, a new account will be configured for you.
Step 5: Social Media
Please share details regarding your business social account
Social platforms in use
Facebook
Instagram
Youtube
Linkedin
Facebook page link
Instagram page link
Youtube page link
Linkedin page link
Step 6: Business Details Continued
Please provide details regarding your practice location(s) and contact information.
Do you have one or more locations?
(Required)
One Location
Multiple Locations
Practice Physical Address
(Required)
Practice Booking Link
(Required)
Practice Phone Number
(Required)
Practice Email Address
(Required)
Practice Fax Number
Practice Opening Days & Hours
(Required)
How many locations do you have?
Please select
Two Locations
Three Locations
Four Locations
Five Locations
Practice 1 Name
Practice 1 Physical Address
Practice 1 Booking Link
Practice 1 Phone Number
Practice 1 Email Address
Practice 1 Fax Number
Practice 1 Opening Hours
Practice 2 Name
Practice 2 Physical Address
Practice 2 Booking Link
Practice 2 Phone Number
Practice 2 Email Address
Practice 2 Fax Number
Practice 2 Opening Hours
Practice 3 Name
Practice 3 Physical Address
Practice 3 Booking Link
Practice 3 Phone Number
Practice 3 Email Address
Practice 3 Fax Number
Practice 3 Opening Hours
Practice 4 Name
Practice 4 Physical Address
Practice 4 Booking Link
Practice 4 Phone Number
Practice 4 Email Address
Practice 4 Fax Number
Practice 4 Opening Hours
Practice 5 Name
Practice 5 Physical Address
Practice 5 Booking Link
Practice 5 Phone Number
Practice 5 Email Address
Practice 5 Fax Number
Practice 5 Opening Hours
Step 7: Services & Treatments Offered
Please tick all the treatments your practice(s) offers under each of the primary treatment headings.
General & Preventitive Treatments offered
Check-up and clean
Children’s dentistry
Dental emergencies
Gum disease (Periodontics)
Jaw joint disorder (TMD)
Mouthguards
Sleep Apnoea and snoring
Select All
Restorative Treatments offered
CEREC
Crown and Bridge
Dental fillings
Dental implant restoration
Inlays/Onlays
Root canal (Endodontics)
Select All
Cosmetic Dentistry Treatments offered
Dentures
Gum lifting
Laser Dentistry
Teeth Whitening
Tooth extractions
Veneers
Select All
Oral Surgery Treatments offered
Dental implant placement
Gum surgery
Wisdom teeth removal
Select All
Orthadontics Treatments offered
Braces
Clear Aligners
Invisalign
Select All
Specialised Treatments offered
Oral Medicine
Sedation
Select All
List up to 6 Key Treatments
(Required)
Out of the treatments you have selected above, list up to 6 key treatments that you would like to feature on the Home Page.
Step 8: Provider, Payments and Associations
Please tick all the Health Insurance Providers and Payment Providers you offer.
Tick All Health Insurance Providers You Offer
AAMI
Apia
Australia Defence Force – ADF
Australian Unity
Budget Direct
Bupa
CBHS Corporate
CDH Benefit
Central Queensland Hospital and Health Service (CQHHS)
Child Dental Benefits Schedule (CDBS)
CommBank Health Cover (CBHC)
Country Patients Dental Subsidy Scheme (CPDSS)
Darling Downs Health Services (DDHHS)
Defence Health
Department of Veterans’ Affairs
Frank Health Insurance
GMF Health Insurance
GMHBA
Great Southern Bank
HBC
HBF
HCF
Health Care Insurance
Health Partners
HIF
Latrobe Health Services
Medibank
Metro North Oral Health Vouchers
Metropolitan Patients Dental Subsidy Scheme (MPDSS)
MyOwn
Navy Health
NIB
Oral Health Fee for Service Scheme (OHFFSS) NSW
Peoplecare
Phoenix Health Fund
Police Health
Qantas
Queensland Country Health Fund
Smile.com.au
South Australia Dental Scheme (SADS)
St Luke’s Health
Sunshine Coast Hospital and Health Service (SCHHS)
Teachers Union Health
Transport Accident Commission
Victorian Denture Scheme
Victorian Emergency Dental Scheme
Victorian General Dental Scheme
Westfund
WorkSafe
Other
Select All
You selected "Other" for Health Insurance Providers. Please list all other Health Insurance providers you offer.
Tick all Payment Providers You Offer
Affirm
Afterpay
Credit Card
DentiCare
GoCardless
Humm
Klarna
Latitude Pay
National Dental Plan
Sezzle
Splitit
Supercare
Paypal
Zip Co / Zip Pay
Other
Select All
You selected "Other" for Payment Providers. Please list all other Payment Providers you offer
Tick All Associations you are a part of
Australian Dental Association Inc
Australian Academy of Dento-Facial Aesthtics
Australasian Osseointegration Society Limite
Australian Society of Endodontology
Australian Prosthodontic Society
Australian Society of Periodontology
Autism Friendly – Autism Initiative
Dental Practice Accredited – QIP
Dental Care Network (A DNC Dentist)
Other
Select All
You selected "Other" for Associations. Please list all other Associations you are a part of
Step 9: Content
Please confirm the following details regarding your website content
Does your website have a news/blog section?
(Required)
Yes
No
Would you like your news/blogs transferred?
Yes
No
We will review all news/blogs published in the last two years and migrate over those that meet our content guidelines.
Do you have photos taken at/of your practice?
(Required)
Yes
Not yet, but we are having photos taken soon
No, please utilise stock imagery from the Bupa library on practice specific pages
How would you like to supply your practice photography and imagery?
The images you supply will be used to visually communicate your business’ unique identity. All imagery must meet a minimum web quality standard. When packaging up your images, please ensure all images are of high quality and are offered in a variety of formats and shapes for website usage. If images do not meet this standard, we will utilise imagery from the Bupa image library.
I would like to upload my images here
I will send my images later
Photos and imagery can be taken directly off our website
Practice Photos (used for banners and other areas on the site)
Drop files here or
Select files
Accepted file types: jpg, png, svg, pdf, gif, Max. file size: 40 MB, Max. files: 20.
Please provide a description of your practice to be used in the "About Us" section
This content will be re-written to ensure it aligns with the new site structure. Minimum 250 words
Do you have a specific order you would like the dentists, or any other staff, to appear on the site?
If yes, please list them in the correct order here (first name being the first person to show in the row).
Is the practice wheelchair accessible?
(Required)
Please type a list of your most common Frequently Asked Questions (FAQs)
Do not paste a link to your current FAQs. Please type them in the box below. These questions relate specifically to your practice and are NOT questions about your treatments or services.
You can view some ideas/examples here:
https://ibonboarding.boylenplus.com/example-faqs/
Are there any additional features of your practice that you would like to highlight?
This does not include content related to treatments, payment providers or health funds, but can be used for practice specific information such as accessibility options, language services, neurodivergent experience, family friendly offerings etc.
10. Feedback and Submit
Do you have any further information or feedback to include?
General form feedback
Please provide any feedack
CAPTCHA