Client Worksheet
Client Name: Phone #

Zip Code: Radius Desired: I.D. Code:

Prospects Available: Click Here to use our online estimating tool
(10,000 minimum)

Client Signature Date
Down Payment Budget
Setting up my ENewsletter template and Admin Dashboard is $799:
$799.00
Prospect Email List Purchase: (Quantity X 2.5¢)
$0.00
TOTAL DOWN PAYMENT:
$0.00
Monthly Budget
Creating my monthly ENewsletter issue is: FREE!
Emailing my ENewsletter to my patients each month is: FREE!
Requesting new articles to be written about Current Events is: FREE!
The “Send This ENewsletter to a Friend” list-building feature is: FREE!
The "Refer a Friend to Our Practice" new-patient-building feature is: FREE!
The "Request an Appointment" schedule-building feature is: FREE!
Monthly E-Postage*: (Quantity X 2.9¢)
* Updating your list monthly will change your list total and your e-postage every month (see below)
$0.00
TOTAL MONTHLY PAYMENT:
$0.00

(3¢ each)
Fax to Dental EMarketing at 1-320-363-0218