Pearl Street: Practice Information

Practice Name*

Practice’s main phone number for forwarding tracked numbers (Not currently a Tracked Line)*

What email would you like website forms sent to?*

Domain Access

Domain URL*

Where is the domain located? (GoDaddy, Namecheap, Current Provider owns, etc)*

Are We Transferring This Domain?*

If domain is in a GoDaddy account, please send the current owner the Pearl Street GoDaddy information provided to you. The current owner will have to initiate transfer.

If This Domain is NOT in GoDaddy we need the domain unlocked and the EPP code provided to us by the current wonder.

EPP Code

FTP Access

FTP Host

FTP Port

FTP Login

FTP Access

Custom Website Features To Migrate

Chat URL/Code

Payment URL/Code

New Patient Forms URL/Code

Scheduling Link URL/ Code

Patient Portal URL/ Code