Top Doctors Practice Profile: Client Info Form

Top Doctors is a formatted ad section in the May issue of Philly Mag exclusively for 2019 Top Doctor winners. Each profile includes a professional photo taken by our team, information about your Top Doctor winner(s) and practice, and practice contact information. Please look through the deadlines below closely and let us know if you have any questions or concerns.

Important Deadlines

March 15th: Fill out this brief form as soon as possible, or no later than the 15th. We’ll be in touch promptly with interview questions and to schedule your photoshoot. Note: Hair and makeup will not be provided. While we will lightly edit your photo before it goes to print, photoshop is not included.

March 22nd: Your photoshoot should take place no later than the 22nd. You’ll sign off on your image choice at the photoshoot, and the photographer will send us an edited version of your choice. Once we have your image and your interview responses, we’ll get to work making your profile.

April 1st: Expect to receive a proof of your profile by this week. You’ll have about 48 hours to review the profile with your team and provide us any edits and feedback. We can make up to two rounds of changes to your profile.

April 5th: Final sign-off on your profile is due by end of day.

April 29th: The issue is on sale! Make sure to check out the Top Doctors special section to see your profile.

Contact Name*
For internal use only.
Contact Email*
For internal use only.
Contact Phone*
For internal use only.
Practice Name*
This will be the header of your profile.
Practice Website*
Note: the URL will appear all lowercase and without the "www" in print.
Practice Phone*
Practice Address*
Street Address Address Line 2 City State / Province / Region
Additional Addresses/Contact Info
Please list in order of importance as we may not be able to fit all addresses.
Top Doctors Names*
Please list names and letters for all Top Doctor winners who will appear in the profile photo.
Body Copy*
Please draft 340 words max of body copy for your profile. This can be about your Top Doctor winners, their specialties, anything innovative your practice is doing, your treatment philosophy, or anything else you'd like to focus on. Note: We'll edit your copy to meet Philly Mag style guidelines—including using third person. A long photo caption may limit your body copy space. We cannot guarantee how many words will fit in your profile.
Photo Use*
- No, I do not want to receive the rights to one (1) photo. I understand that I do not own the rights to it and this photo may only be used for advertisement purposes within Metrocorp, INC branded publications
- Yes, I want to receive the rights to one (1) photo to use outside of Philadelphia magazine (additional fees apply per the photographer)
I acknowledge that cancelling my photoshoot without giving 24 hours notice will incur a fee of $300 from the photographer.*
- I agree to the terms above
I acknowledge that my contract includes one photoshoot, with my final photo to be selected on-site at the time of my photoshoot.*
- I agree to the terms above.
I acknowledge that my ad includes two rounds of copy revisions and any additional revisions will incur a $25.00 fee per revision.*
- I agree to the terms above.