Top Dentists: Client Informational Form (Practice Profile)

Top Dentists is a special section in the March issue of Philadelphia magazine highlighting the region’s top dental experts. Your profile will consist of a photo, contact information and a description of your practice. Please fill out this form completely at your earliest convenience or no later than January 11th.

IMPORTANT DEADLINES

January 11th: Please submit this form by end of day. We’ll be in touch to schedule your photo shoot.

January 23rd: Expect to see a proof of your profile for your review.

January 28th: Any feedback or corrections to your profile are due. Once we get your feedback, we’ll aim to send you a new proof within 48 hours. Please make sure to gather all feedback into one, clear email as we can only make up to three rounds of changes.

February 1st: Final sign-off on your profile is due by end of day.

February 26th: The issue is on sale! Make sure to check out the Top Dentists special section to see your profile.

Contact Name:*
Contact Phone Number:*
Contact Email Address:*
Practice name for header:*
Specialty:*
Address:*
Phone Number:*
Website URL:*
Body Copy:*
Please provide one paragraph with information about your practice such as: Your specialties, your approach to care, your practice's history, or your accreditations. For a full page profile, draft about 170 words. For a half page profile, draft about 70 words. Please note that Philadelphia magazine will edit the content to adhere to section standards and the magazine's style guidelines.
Top Dentists: Years Awarded*
Please specify desired photography session date:*
MM slash DD slash YYYY
Please specify desired photography session time:*

: Hours

Minutes

AM/PM
I acknowledge that my ad includes 3 rounds of design/copy revisions and any additional revisions will incur an additional fee per revision.*
- I have read and agree to these terms above.