Implementation Questionnaire

Welcome to Pacify!

This document includes information and questions that will facilitate a swift and seamless implementation.

Please complete these questions relating to gift box customization, platform set up and reporting. If you have any questions, please email [email protected].

We look forward to working with you!

About You

We are so excited to implement Pacify into your organization! And before we dive into customizing your employees’ experience, we would like to learn more about you and your organization. Please tell us about your team and employees:

Submitter Name(Required)

First Last

Organization(Required)

Submitter Email(Required)

Please list the names, roles, and emails of the team members we will be interacting with:(Required)

Number of eligible employees:(Required)

Number of births per year:(Required)

How do employees learn about their benefits?(Required)

Do you offer other telemedicine programs?(Required)

Yes

Please tell us about the other telemedicine benefits you offer:(Required)

Enrollment and Gift Box Customization

Upon enrolling through a dedicated web page, each employee will receive a welcome email containing their unique access code, as well as a baby shower gift box shipped directly to their home address.

This gift typically contains:
• A Pacify membership information card
• A card with a unique access code to the Pacify app
• A Pacify branded note pad and pen
• A Pacify FAQ
• A customizable note card
• A Pacify branded or custom company onesie (Pacify onesie size is 6 months)

Landing Page

How should employees enroll in Pacify?(Required)

Employees enroll directly through the landing page

HR enroll on behalf of employees

Both (Employee + HR access)

This will determine the layout of the landing page.

Please provide a list of all team email addresses that should receive employee form submission confirmations:(Required)

Please write N/A if you do not need to receive employee form submissions

Baby Shower Gift

Do you wish to customize any of the following elements?

Note card literature (5x5 insert)

Branded onesie

Platform Services Offering

This section will help you to identify and finalize what services will be available for your employees once they log into the Pacify application. The core services offered by Pacify are a Lactation Consultation video-enabled line and a Nurse Advice Line (audio only). You can additionally bring in programs your organization plans to have or already has available for employees today. Some examples of platform services include:

Lactation Consultant with Pacify IBCLCs
Pacify Nurse Line
[Company] EAP
[Company] Mental Health & Wellbeing Line
[Company] Quit Smoking Line

[Company] is customizable to your organization. An average phone screen will fit 5 buttons on the screen. An organization will generally include 3-5 buttons.

The image below shows the Pacify app setup with a Lactation Consultant, Nurse, and EAP button. A member will be able to click on the information icon in the top right of each button to see a description of the service. This description will include topics members can call about, phone tree navigation, and hours of operation. The image below shows an example of the description window:

SFTP Server

Note: Reports may contain PHI

Please provide a list of team members + email addresses you would like to receive secure email reports:(Required)

Please provide the following information regarding your secure SFTP:

Server(Required)

Port(Required)

Username(Required)

Password(Required)

Pacify will provide the following information to you:

File Type
File Directory
File Naming Convention