Advertising Request Form

This request form is designed to streamline the advertising (print, online, TV, direct mailer) customization process by having all relevant information in one place. Before completing the form, be sure you have all relevant information from the publication or printing company, where applicable (e.g., dimensions, deadline, preferred file type, color/black and white). The email address/name provided will serve as the main point of contact for all communication related to the request.

Dimensions should be written as width x height in either inches (for print) or pixels (for online).

It is important that you copy the file name EXACTLY as it appears on the Marketing Showcase (e.g., Centennial 4×5 ad_Recipe_Pina_ Colada_V2.pdf) so that our graphic designer can easily access the template.

For more detailed tips on selecting a template, please view the Advertising Request Form Guide above

Unique Ad Name*

Contact Name*

Contact Email*

Dimensions (width x height)*

Unit*

Resolution (DPI)*

Desired File Format*

Black & White or Color*

Template File Name*

Please copy the file name EXACTLY as it appears on the Marketing Showcase.

Changes / Customizations

Please note that the graphic designer will copy any text changes exactly as you type them so it is important that you carefully review your work for grammar and spelling errors before clicking “Submit Ad Request”. With this new process there will only be 2 rounds of revisions allowed, so please also keep that in mind.

HCA Logo Preference*

Office Phone Number*

Website URL*

Upload Supplemental Files, Max. File Size: 2MB (If you will be including a head shot, Best of Home Care logo, etc., you can upload the hi-res file by selecting "Choose File" above.) Note:Accepted files: jpg, png, gif, pdf

Deadline (yyyy-mm-dd)*