Dentist Signup Confirmation

Alberta 1-866-344-0533 OR 780-702-2706

Please review and complete the billing confirmation form below.
This is a very important piece of completing your Account Setup as a new hosting client.

  • Contact Information

  • Billing Information

  • Terms and Conditions

  • Fees & Payments:
    - Support & Hosting fees are $29.95 per month (plus any additional optional add-on service fees if applicable) beginning the month that your site set up is complete, regardless of whether or not your website has been launched on your domain
    - Fees are due June 1st and December 1st for the following 6 month periods of July – December, and January to June respectively.
    - Overdue and unpaid accounts will be automatically cancelled within 60 days of non-payment and files removed from our server.

    Cancellation Policy:
    - You can cancel services at any time however, if you cancel within the first 6 months after your website was completed, a one-time cancellation fee of $188.69 will be due.
    - Templates remain the property of SiteWyze Solutions.
    - Should you cancel your website hosting services with us, you are free to take any content (text and images) that you provided to us for use on your next website, however, all other site files remain the property of SiteWyze Solutions.
    - Cancellation must be provided in writing prior to the next billing cycle (July 1st or December 1st).
    - There are no refunds if you cancel your hosting in the middle of a paid hosting period.
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• All site-related and email technical support
• All CMS training & assistance
• Website hosting
• Email hosting (includes up to 10 free email accounts)
• Daily Site Backups, and ongoing Advanced Site Security


Hosting is billed twice a year: June 1st (for Jul 1 – Dec 31) and December 1st (for Jan 1 – Jun 30).

Billing will begin the first month that your site setup is completed, regardless of whether your site is live on your domain.


Automatic billing: we will send you a notice a few days in advance, and will bill the credit card on file on the billing date. Once we receive your billing information from this completed form, we will send you an authorization form to complete if we do not already have your card on file.