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aaron.kruglyak
2021-08-25T16:06:47+00:00
Web Maintenance Request Form
Site Maintenance - WF Active 1.0
1
Contact Information
2
Request Details
Contact Information
Full Name
*
First Name
Last Name
Title
--Select
DBD
CEO
Divisional DBD
Other
Email Address
*
Facility Name (please provide full facility name)
*
URL
This is either the main facility URL, or direct link to a page that needs edits.
Request Details
How can we direct your request?
*
--Select Request Type
Update Website
SEO
Google Analytics Report
Choose Request Type
*
Update Website Photos
Update Facility Photo Gallery
Add Video
New Page
Update Existing Content
What Needs to be Done?
*
How Urgent is This?
*
1 (Minor - Nice to have, not critical)
2 (Moderate - Preferably done ASAP )
3 (Serious - Time Sensitive)
4 (Urgent - Something on site is incorrect/broken)
5 (Critical - Patient health risk)
Desired Completion Date
*
MM slash DD slash YYYY
Based on our current priority and capacity we may not be able to meet that date. A member of our team will contact you to provide a timeline if the requested date cannot be met.
Does this request impact content on findbhhelp.com?
*
Applicable if facility is listed in the UHS Universal Directory and appearing on
findbhhelp.com
.
Yes
No
What aspects of your request will impact your listing on FindBHHelp.com?
Photos
Address
Phone Number
URL to main website
Hours of Operation
Description
Treatment Services/Major Program information
Specialty Programs
Other
Additional Details for FindBHHelp.com
Please provide any additional details to clarify what changes will impact your facility's listing.
File Upload/Supporting documents
If an error with the file upload occurs, please send to
[email protected]
via
UHS' Web Transfer Client
Drop files here or
Select files
Max. file size: 50 MB.
Add Videos
Video Was Approved
*
YES
Who Approved Video Within The Agency?
*
Is Video Included in Request?
*
Yes
Requests submitted without video included will be delayed/unfulfilled.
Is the .srt file (close captioning) included? This is required before submitting IF the video has audio.
*
YES
NO
Email
This field is for validation purposes and should be left unchanged.
