Website Questionnaire

Web Design Getting Started Questionnaire

Welcome to the website questionnaire. In the next 30 minutes or so you'll give us all of the information we need to make you an amazing website that helps you convert traffic into leads. Please note that in an effort to keep our costs down that we do not accept design revisions on pay-as-you-go websites and that design revisions on semi-custom websites are billed by the hour. As such, please take the time to fill this form out in as much detail as possible - what you put into it is what you will get out of! 

*This form might not save. If you don't complete the form in one sitting, submit what you have done, and then come back and finish the rest as soon as possible. 

Part 1 - Getting Started
Nameyour full name
Clinic Name
Website URL
Point of Contact Name
Contacts Phone #

If you know your domain registrar login information please provide it below. If not, please start trying to find it, as we will need it to launch your new website.

Domain RegistrarGo Daddy,, Enom etc.
Registrar Username
Registrar Password
Part 2 - About Your Business

Tell me a bit about your current customers (Gender, Age, Household Income, Relationship Status, etc). What emotions do they have? WHY do they  want your product? What feelings do they have?

Audience Notes
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Tell me a bit about your customers preferences...

Product / Service Quality

Your target audience has a list of BUYING CRITERIA that needs to be satisfied before they make a purchase decision. What pieces of information are your audience looking for?Ex: Proximity, service offerings, technology, quality, parking availability, transit access etc.

What are all the things your customers care about when it comes to making a decision and why should someone choose you instead of your competitor?

Buying Criteria
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Similar to the last, what are 4 things that you can brag about, that your competitors cant? (These are called differentiation factors or proof points) Ex: 150 5 star reviews, 25 years in business, awarded best clinic in the city, obtained 25% more education credits than required, professor at the university....Why should someone choose YOU?!

Proof Points
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Part 3 - Services & Equipment

In this section I need to know everything you do! Check off all of the boxes below. If you offer any services not on the list make sure you add it in the comments. 

Please list ALL of the services you offer.
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Please list the main conditions you treat.
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What pieces of equipment do you use that set you apart?
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Part 4 - Your New Website

We need to make sure your new website is better than your competitors. List 3-5 competitors close to your office. 

Competitor Websitespaste in their URL
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List a few websites that you love the look and feel of. Outline what you like and dislike about the inspiration sites. 

Inspiration Sites
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Outline what you NEED on your new website and some things on the wishlist that would be nice to have.

New Website Requirements
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New Website Wish List
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What are your company colors, font's, and branding components?
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I want my new website to be

Please upload any headshots, office images, before and after cases, or any other images you feel would help the design of your site. 

Part 5 - Content
In 250 words or more please tell us about your office
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Please provide a bio for each clinician
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If you have any YouTube videos, please place the links here
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Please paste some patient testimonials here
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What is your mission statement?
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What are your core values?
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Contact Us PagePlease provide all of the content you wish to display on the contact page.
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Office PoliciesPlease provide any office policies customers should know about
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If you think we might be missing something, here is the place to put ANY INFORMATION that you have not provided us above.
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CommentsAny comments, questions, or requests for us?
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