PLEASE FILL OUT AS MANY FIELDS AS YOU CAN. ONCE WE RECEIVE YOUR INFORMATION, A CUSTOMER SERVICE REPRESENTATIVE FROM OUR STOCKTON CCAIFORNIA ANSWERING SERVICE WILL CONTACT YOU TO REVIEW AND COMPLETE SETUP OF YOUR 7 DAY (1 WEEK) FREE TRICA. WE WILL CONTACT YOU SHORTLY AFTER WE RECEIVE YOUR INFORMATION TO REVIEW YOUR INFORMATION AND YOUR PROCEDURES AND GET YOU READY TO START SERVICE. MANY TRICA ACCOUNTS CAN BE SETUP WITHIN AN HOUR.
Preferred Start Date: (month/day/year)
Company Name: Web site Address:
Answer Phrase: (greeting to use when picking up your lines)
Business Description / Services You Provide:
Estimate of Monthly Call Volume:  < 25    25 - 50    50 - 75    75 - 100    100 - 150    150 - 200    200 - 250    300 +  
Primary Office Contact:
Main Phone #: Back Line #: Fax #:
Do you want a copy of your messages faxed or emailed in the morning?  neither   both   fax only    email only

If "Yes" to fax or e-mail, what time would you like the messages sent? am pm

If report is to be emailed, list email address report should be sent to (you may list multiple addresses)

Physical Address:
Billing Address:
Office Hours: Time Zone:
Hold Calls Overnight: (If "Yes", we would contact you with every call. If "No", we would only contact you with the calls you specify)?
If you answered "Yes", what times should we hold your calls from (please specify am or pm):

to
Information Needed on Message Ticket:
*Name, Phone, & General Message are always taken, Please include all other information we need from your callers
Please list the type of calls that should be dispatched immediately: (list the type of calls you need to be contacted ASAP for - such as any call you would consider an emergency - all other calls will be held for the office until the next business day)

On call Staff Names, Contact Numbers, and Schedules: If this is too much information to list here, please email us here or fax us at 1-888-644-4129 - be sure to include your company name on all correspondences

Contact Instructions: (list instructions and procedures for emergency calls we need to contact you ASAP for as listed above.)

If we can't reach your on-call staff in what steps should we take:

**Form Verification
Type In The Code 1923