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ACA-Track Partner Website Form

Use this form to initiate the development of your ACA-Track™ Partner Web site. Please note, if you indicate “Custom” for any of the site content elements, you will be prompted to provide content/link/information within this form. Once your form is complete, please click the “Submit” button at the bottom of the page.

If you have any questions regarding this form or your Partner website, please contact the ACA-Track Partner Concierge, 1.800.488.7395.

Thank you for being an ACA-Track Partner!

Partner Information*
First Last
Phone*
Email*
Company Name*
Please upload partner logo here
File
Accepted file types: jpg, png, tiff, Max. file size: 128 MB.
Please resize your logo to 235 × 109 pixels
Menu
Menu Items
- About ACA-Track (standard)
- Business/Organization (standard)
- School Districts (optional)
- Blog (optional)
- Support (optional)
- FAQ (optional)
- Request a Demo (optional)
- Signup for Webinar (optional)
Homepage
Homepage Options
- “What they are Saying” Testimonial block
- Standard Content
Add Testimonial 1
Please follow this format: Quote (no more than 300 characters), First name and initial of last name, and Job title (ex. CPA, President & COO / Benefits Administrator)
Add Testimonial 2
Please follow this format: Quote (no more than 300 characters), First name and initial of last name, and Job title (ex. CPA, President & COO / Benefits Administrator)
If you have more than two testimonials please upload a word doc or PDF with your testimonials.
Upload File
Accepted file types: doc, pdf, Max. file size: 128 MB.
NOTE: There is a 5 testimonial maximum. If you have 3-5 testimonials please upload a word doc and follow the format per Testimonial: Quote (no more than 300 characters), First name and initial of last name, and Job title (ex. CPA, President & COO / Benefits Administrator)
Contact Us Form
Contact Us Options
- First Name
- Last Name
- Business/Organization
- Phone
- Email
- Comment/Question Box
Email

Please add the email(s) you would like to have notified for the contact form
Request Demo
Request Demo Page
- Standard Content
- Custom Content
Add Demo Page Custom Content
Email

Please add the email(s) you would like to have notified for the request demo form
Request Demo Page Form Fields
- First Name
- Last Name
- Business/Organization
- Email address
- Number of employees
Signup for Webinar Options
Sign Up for Webinar Page
- Custom Content
- Custom Dates
- Link for off-site Registration
Add custom content for webinar page
Add custom dates for webinar page
Add links for off-site Registration
Email

Please add the email(s) you would like to have notified for the sign up for webinar form
Blog Option
Blog (Navigation Only)
- Link to Partner’s off-site Blog page
- Link to ACA-Track.com blog
Link to partner's off-site blog page
Add link here
Support Option
Support Page
- Standard Content
- Custom Content
Add custom content for support page
Email

Please add the email(s) you would like to have notified for the support form
Other Options
Other
- Partner's Contact Phone Number
Phone
Please add any additional questions or comments here

Information provided by PSST, LLC concerning the Affordable Care Act is not legal advice and should not be treated as such. If you have questions about how the Affordable Care Act will affect you as an employer, please consult legal counsel.

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