What the site asks for
A name, a work email, a role, a practice name, a city, and a short note. The note must not include patient names, dates of birth, record numbers, phone numbers, photos, or screenshots. A checkbox asks you to confirm that. See the no-PHI policy.
What this preview stores
Nothing. GoHighLevel form IDs are placeholders in one config file. Until they are replaced, the browser only opens a thank-you page. No email is sent. No list is updated.
What a connected form would do later
Send the fields to PXC's CRM so someone can reply. That vendor would be the processor. You can ask for a deletion by emailing admin@patientexperienceconsulting.com or calling (941) 239-2309. PXC does not sell contact lists.
Analytics
Analytics are off in this build. If they are turned on later, they should not record form fields or patient details. Do not put secrets in a URL.
PXC is based in Bradenton, Florida. A street address is not published.