Create Facility Profile

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Facility Information

Facility name *

Facility type *

Main phone *

Fax

Main email *

Website

Physical address *

Same mailing and billing address

Billing address (if different)

Primary Contact

Primary contact serves as the facility admin — they own this account and control facility settings, billing, and staff passcodes.

Name *

Title

Email *

Phone *

Password (min 8 chars) *

Confirm password *

Also give a second email address full facility admin access. They'll receive an invite to set their own password.

Staff Access Passcodes

Personnel and billing staff sign in to your facility dashboard with a 5-digit passcode you set here. You can view and change these later in your admin settings.

Personnel passcode (5 digits) *

Billing passcode (5 digits) *

Payment Method (optional — can be added later)

Preferred payment type

Bank account (ACH)

Used for ACH debits when invoices come due. Stored securely; only billing staff can view.

Account holder name

Bank name

Routing number (9 digits)

Account number

Account type

I authorize Givens Transit to debit the bank account above for invoices owed by this facility.

Credit / debit card on file

Do not enter a full card number here. Record the brand, last 4 digits, expiration, and billing ZIP for reference; secure card capture happens at checkout.

Brand (Visa, MC, Amex…)

Last 4 digits

Exp month (1-12)

Exp year (YYYY)

Billing ZIP

New facility accounts are reviewed by Givens Transit before activation. You'll be able to fill out transportation and billing preferences inside your dashboard after creating the account.