Levitate Integration Request

Levitate Integration Request

Please complete the form below to request IMS / Connect integration with Levitate.

Date *
N/A

MM/dd/yyyy
Agency Name *
N/A
Name
N/A

Required First Required Last
Email *
N/A
Phone *
N/A

### ### ####
Does your agency have a current Levitate account? *
N/A

Yes
No

Your agency must have an active account with Levitate to proceed with integration.
Current Xanatek Product Version *
N/A

Connect
IMS4 - Xanatek Hosted - Xanatek stores your data
IMS4 - Data not hosted by Xanatek - Your data is stored on a server in your office or with a third party

Please let us know if you are using IMS4 or if you have access to Xanatek Connect.
Do you have Admin rights in IMS4? *
N/A

Yes
No
Levitate Representative (if known)
N/A

Please provide the name of your Levitate Rep (if known)
Agency State *
N/A
Levitate Rep Email
N/A
Levitate Email
N/A
Levitate Email 2
N/A
Notes
N/A
Xanatek Territory Rep Email
N/A
Training Email
N/A

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