AM Virtual Services, LLC
Client Registration Form
Account Name:
*
When do you want to begin service?
*
-
Month
-
Day
Year
(Please allow up to 3-5 business days for processing and programming).
Office Number:
*
This would be the number your callers use to get in contact with you.
Fax Number:
Office Physical Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your mailing address different than your physical address?
*
Yes
No
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
This email address should be one that can be given to your callers if they ask for an email address for your company.
Website:
Business Hours:
*
OPEN
CLOSE
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Primary Contact's Name ( person in charge of the account)
*
First Name
Last Name
Primary Contact's Number
*
This is the number messages and urgent calls will be forwarded to.
Primary Contact's Email
*
Do you use Internet Phone Services (VOIP)?
*
Yes
No
Unknown
If answered yes, does your Internet Phone Services(VOIP) provider allow you to forward to Toll Free Numbers?
Yes
No
What company is your office number serviced with?
*
ex: Verizon, Comcast, Century Link etc
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Next
What services do you provide?
*
Funeral Homes
Cremation Services
Service provider (Refrigeration, HVAC, plumbing, etc)
Real Estate
Property Management
Healthcare
Legal
Higher Education
Veterinary
Other
Please provide a general description of the services you provide.
When do you require answering services?
*
Business hours
24/7
After hours
Overflow/Rollover Calls Only
Average of calls you need serviced on a daily?
*
0-10
11-30
31-50
51+
What services are you interested in? (check all that apply)
*
Customer Service Support
Virtual Personal Assistant or Receptionist
Service Dispatch
Secure Messaging
Order Entry Services
Overflow/Rollover Service
Appointment Scheduling
Wake-Up Service
Help Desk Support
Other
Do you require HIPAA-trained agents?
*
Yes
No
How should we answer your calls?
*
"Answering for (Business Name)
"Thank you for calling (Business Name)
(Business Name) how many I help you?
Other
Do you require bilingual agents?
*
Yes
No
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Next
Message Relay Instructions:
*
Ie. Text/call doctor for all emergencies. Forward calls related to plumbing to George. Email Susan for billing inquiries.
Contact 1
First Name
Last Name
Title:
Phone Number
-
Area Code
Phone Number
Email:
example@example.com
Contact 2
First Name
Last Name
Title:
Phone Number:
-
Area Code
Phone Number
Email:
example@example.com
Contact 3
First Name
Last Name
Title:
Phone Number
-
Area Code
Phone Number
Email:
example@example.com
Comments:
Signature
Submit
Should be Empty: