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Website design questionnaire

Website design and Development project starts here.

Fill out the form below for Web design and development or call us with any questions (415) 500 5333.

- 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*
- - Point person for this project name*
- - The email address of the pointed person*
- - Phone number of the contact person*
- - How long have you been in business?*
- - How many employees do you have?*
- - How many locations do you have?
- - What does your practice do? (Please list each service and/or all products you offer)*
  - What is your main USP? (Unique Selling Point)*
  - What’s your practice’s vision? (Example: Open new locations, Grow my practice*
  - What’s your practice’s mission?*
  - What does your practice do? (Please list each service and/or all products you offer)*
- Name your 3 main competitors?
- - 1.
  - 2.*
  - 3.
- Target audience
- - What is your primary audience category?
  - What is your primary audience category?*
    - Companies
    - Patients
    - Companies & Patients
- - Targeted Patients
- - Your target location
- - My site will be built to target:*
- - Targeted Companies:
- - Your Target location
- - Your Target Industry
- - Your Target Company Revenue Size*
- - Your Target Company Size*
- - Why should your customers choose you?
  - - I offer excellent service
    - I have the best products on the market
    - I have the best prices on the market
- - What problems do you solve for customers?
  - What differentiates you from your competitors? (why do patient buy from you instead of your competitors?)
- Website project detail
- - 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 my 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:*
- - What social media sites do you like to incorporate into the website? (Please provide the profile link)
- - Facebook
  - Your Facebook Profile link
- - Linkedin
  - Your LinkedIn Profile link
- - Instagram
  - Your Instagram Profile link
- - Pinterest
  - Your Pinterest Profile link
- - Twitter
  - Your Twitter Profile link
- - Google
  - Your Google My Business link
- Design Stuff
- - What are three words that best portray your company’s image?
    - Professional
    - Modern
    - Simple
    - Fun
    - Creative
    - Polished
    - Kids Friendly
    - Patient Centric
- What elements of your existing site do you like, and what do you not like?
- - Do you have brand guidelines, logo(s), and brand colors to incorporate into the site?
  - - Yes
    - No
- - Attach your design or guideline here
    Drop files here or
    
    Max. file size: 1 GB.
- Domain, Hosting & Maintenance
- - Do you need us to buy your domain?
  - Do you need us to buy your domain?*
    - Yes
    - No
- - Do you need us to handle hosting?
  - Do you need us to handle hosting?*
    - Yes
    - No
- - What is your current website URL?
- - Do you have specific URLs or keywords in mind for your website?
- - Do you own any other domains or sub domains?
- - Where is your current site hosted?
- - Will you need monthly maintenance and updates after launch?
  - Will you need monthly maintenance and updates after launch?*
    - Yes
    - No
- - Do you use an email marketing service that you’d like integrated?
  - Do you use an email marketing service that you’d like integrated?*
    - Yes
    - No
- Digital Marketing & Analytics
- - Have you preformed SEO on an older or current version of your existing site?
  - Have you preformed SEO on an older or current version of your existing site?*
    - Yes
    - No
- Please provide key phrases you target in search engines.rovide key phrases you target in search engines.
- - Does any analytics implement on your current site?
  - Does any analytics implement on your current site?*
    - Yes
    - No
- - Does any advertising tracking code is already implemented on your current site?
  - Does any advertising tracking code is already implemented on your current site?*
    - Yes
    - No
- 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.

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