Website Development Order Form

You can use this form if you would like IHR to:

develop a new website
or update your current website look-and-feel

In either case, please first call IHR at 925-284-9362 to discuss your needs. After there is a mutual understanding of your needs and IHR's services, you can submit this online Order Form and mail in a deposit check.

1. Estimate the scope and cost of your website:

Let's estimate the scope and cost of your website project. The actual cost may vary somewhat. You can discuss this with IHR.

a) Estimate the number of web pages:

b) Tell us about any special features that you want on your website (e.g. blogs, online forms, etc.):

c) Based on your conversation with IHR and Typical Website Development Costs page, what is the estimate for your website. Note that this estimate is only a starting place for sending a deposit and getting started.

2. Ensure that you've reviewed the IHR Web Development and Hosting Terms of Agreement

3. Enter the main domain name (e.g. oregonivf.com) of your website:

4. If applicable, enter the following additional information about your website domain name(s):

If you own other domain names that you want hooked up to your website, enter all of those domain names below.
If you would like IHR to help you select a domain name, please indicate that below.

5. Check off whether you will use your domain name in your email address or whether you'll use your ISP's email address.

Check one box below	Type of email
	"I'll use my ISP's Domain Name in my email address" - e.g. fertilityclinic@aol.com.
	"I'll be using my Domain Name in my email address" - e.g. info@myfertilityclinic.com. IHR will need to do extra setup work with you and your current ISP to set this up.

6. Enter any special instructions below, such as:

Do you use one domain name for your web address and another domain name for your email address?
Do you know if you have your own email server in your office?

7. Enter the following information about you and your organization:

Your Name
(First, Last):

Your Title:

Organization:

Your Telephone:

Your Email Address (required):

8. Enter billing information:

Billing Contact Name
(First, Last):

(If different from your name)

Billing Street Address:

City:

State:

Zip:

Country:

Billing Contact Telephone:

(If different from your telephone)

9. Send payment:

Please send 50% deposit check or money order (payable to "Internet Health Resources") to

Cliff Bernstein
Internet Health Resources
1133 Garden Lane
Lafayette, CA 94549

If you wish to discuss any of the above details prior to submitting this form, please contact IHR.

10. Click the Submit button below.

By completing this form you are agreeing to:

Your Name (First, Last):
Your Title:
Organization:
Your Telephone:
Your Email Address (required):

Billing Contact Name (First, Last):	(If different from your name)
Billing Street Address:
City:
State:
Zip:
Country:
Billing Contact Telephone:	(If different from your telephone)

Website Development Order Form

Quicklinks - IHR Services for Fertility Organizations

Quicklinks -
IHR Services for Fertility Organizations