Website Questionnaire – For Quote

- Your Practice Information
- - - Your First Name*
  - - Your Last Name*
- - Phone Number*
- - Your Email*
- - Your Roll in The Practice*
- - Practice Name*
- - Current Practice Website, if any*
- - What kind of practice are you? (Ex: Pediatric Dentistry, Orthodontist… )*
- Name your 3 main competitors?
- - 1.
  - 2.*
  - 3.
- Website project detail
- Is this a new website?
- - - Yes, I needs a new website.
    - No, I need to redesign my current site.
  - Please provide the URL
- - What is your budget for this project?
  - What is your budget for this project?*
- - What is your project ideal launch date?
  - MM/DD/YY*
- - What type of website do you want to create?*
    - Static Personal or Business Website (no need to modify contents or adding new pages after the website is created and launched.)
    - Dynamic Business Website (You may modify the contents, add new pages, and post article/blog on your site, but you can’t sell products on it)
    - eCommerce Website (You’ll have all the dynamic website type have, and you can sell products on it.)
- - I want this site because (select as many as you need):
  - - I need to build awareness for my brand and Practice
    - I need to generate New Patient Appointments
    - I need to sell product/service through my site
    - I need somewhere to promote my latest product/service
    - I need to use it to build patient loyalty
    - I need to offer a contact point to my patients
    - I need my practice to have a better image online
    - I need to reach people in many languages
- - I have my own reasons:
  - Will you sell products and accept payments on your website?*
  - Will your visitors have an option to login?*
- Your new website would need to include (select as many as you need):
- - *
    - Responsive design for use on tablets & mobiles
    - Online magazine
    - Online forum/ blog
    - Newsletter system
    - Social network integration
    - Intranet system
    - Separate, dedicated landing pages for each service or product
    - A re-design of a current website
- - What actions would you like a user to take when they visit your site?*
    - Call you
    - Fill out a contact form
    - Fill out a quote form
    - Sign up for your mailing list
    - Schedule an appointment
    - Search for information
    - Purchase a product(s)
    - Find your contact information
- We want the following special features to be included in our new website (select as many as you need):
- - We want the following special features to be included in our new website
    - Calendar
    - Online Scheduling System
    - Registration form
    - Video streaming
    - Chatbot
    - Pop up
    - Call Conversion Tracking
    - Uploads/ downloads
    - An online store/shopping cart
    - Online payment gateway
    - Blog module
- - Other features
- - What are some pages you will need for your site?
    - Home page
    - Contact
    - Company Info
    - FAQ
    - Services
    - Product
    - Locations
    - Archives
    - Testimonials
    - Links
    - Resources
    - News
    - Client List
- - Other pages you need that are not in here
- Who will provide the following resources?
- - US YOU
  - US YOU
  - Web design
  - Web design
    - Web design US
    - Web design YOU
  - Other print collateral
  - Other print collateral
    - Other print collateral US
    - Other print collateral YOU
  - Professional Logo
  - Logo
    - Logo US
    - Logo YOU
  - Metatags/ description
  - Metatags/ description
    - Metatags/ description - US
    - Metatags/ description - YOU
  - Branding Guideline
  - Branding Guideline
    - Branding Guideline - US
    - Branding Guideline - YOU
  - Font Licenses
  - Font Licenses
    - Font Licenses - US
    - Font Licenses - YOU
  - Stock photography
  - Stock photography
    - Stock photography - US
    - Stock photography - YOU
  - Translation costs
  - Translation costs
    - Translation costs - US
    - Translation costs - YOU
  - Company photography
  - Company photography
    - Company photography - US
    - Company photography - YOU
  - Graphic design
  - Graphic design
    - Graphic design - US
    - Graphic design - YOU
  - Other Artwork
  - Other Artwork/ Illustrations
    - Other Artwork/ Illustrations - US
    - Other Artwork/ Illustrations - YOU
  - Copywriting text
  - Copywriting text
    - Copywriting text - US
    - Copywriting text - YOU
- Is there anything else you’d like to tell us?
- - Other features, tasks, extra pages, content creation…
- That’s all we need for now! Please submit your request.

Step 2 of 2

Please provide the following information for an accurate quote for your website design project.

Website Questionnaire – For Quote

Your Practice Information

Website project detail

Who will provide the following resources?

Is there anything else you’d like to tell us?