IHR Website Promotion Order Form

This is a wide-page template to be used for IHR online forms.

IHR Company Home Page | IHR Web Site Promotion

Complete and submit this Order Form so that IHR will send highly qualified infertility traffic to your website. By completing this form you are agreeing to the Promotional Linking Services Agreement.

1. Review IHR Charges:

Charges for IHR website promotion
For flat-fee listings (i.e., fixed monthly price), the service period is six-months, payable in advance.

2. Select one or more IHR Web pages where you want to be listed:

A. IHR.com Infertility Resources pages are targeted toward consumers/patients:

TIP: To obtain additional traffic, many of IHR's clients order promotional listings on multiple IHR pages. For example, an infertility clinic might order listings on the Infertility Clinics page and the Egg Donor / Surrogacy page.

Infertility Clinics
Egg Donor and Surrogacy Programs
Tubal Reversal Doctors
Vasectomy Reversal Doctors
Counselors and Consultants
Natural Infertility Treatment Services
Preimplantation Genetic Diagnosis ( PGD ) Programs
Male Infertility Doctors
Sperm Banks
Pharmacies Selling Infertility Drugs
Human Egg Freezing Programs
Lawyers
Infertility Products - for Consumers
Financial Options
Embryo Adoption Programs
Nursing Services - Injections
Adoption Agencies
Right-side grey adbar listing on all pages

B. Specialized male infertility websites are targeted toward male patients:

VasectomyReversalSpecialists.com provider pages
MaleInfertilitySpecialists.com provider pages
VaricoceleSpecialists.com provider pages

C. InfertilityProfessionals.com pages are targeted toward infertility professionals:

Suppliers of Products and Services
Right-side grey adbar listing on all pages

3. If your ad will appear on an IHR web page that contains state listings, then enter the state/metro area where you want to be listed:

TIP: To obtain additional traffic, many of IHR's clients order IHR.com promotional listings in multiple states. For example, on the Infertility Clinics page, a client might order listings in New York, New Jersey, and Connecticut (three listings, at $45/month for each listing).

4. Select the total number of promotional listings you want to order:

1 listing 2 listings 3 listings 4 listings 5 listings
6 listings 7 listings 8 listings 9 listings 10 listings
If you want more than 10 listings, contact IHR for volume discounts

5. Enter a maximum 25-word description for each listing:

Descriptions should state your unique benefits and advantages to site visitors
Descriptions cannot contain comparative superlatives about success rates, such as "highest success rates in the U.S."
Additional information in IHR Guidelines for Promotional Descriptions

6. Enter the Web address (URL) of your Web site page that you want listed:

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. Enter any special instructions below, such as:

If you're ordering listings in more than one state, enter the states.
If you want different descriptions for each of your listings, enter the different descriptions.
If you're ordering a Pay Per Click Listing, enter the per-click charge you will be paying.

10. Provide payment information:

For Flat-Fee listings:
- payment by credit card or check is acceptable
- service period is six-months, payable in advance
For Pay Per Click listings:
- credit card payment is required
- service period is monthly, payable after the service
Purchase Orders are acceptable.
When the next payment is due, IHR will automatically send an invoice. Then, if paying with credit card, IHR will charge the credit card number on file, a few days later.
You can cancel the service at any time. Please provide at least 15 days notice.

a) If paying by credit card, complete the following information in this secure order form:

Payment method:

Cardholder name:

Card Number:

Expiration Date:

Customer Code:
Typically a 3-digit code located on the back of your credit card

b) If paying by check, click here :
Send check (payable to "Internet Health Resources") to:

Internet Health Resources
1133 Garden Lane
Lafayette, CA 94549

11. Click on the Submit button below.

By completing this form you are agreeing to the IHR Promotional Linking Services Agreement.

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)

Payment method:
*Cardholder name:*
Card Number:
Expiration Date:
Customer Code:	Typically a 3-digit code located on the back of your credit card