Web Design and Business Information Questionnaire Leave this field blankThis questionnaire is designed to enhance the communication in order to complete your website design project. It will help in the development of the main "look and feel" of your new site and will be used develop a preliminary home page for your approval. The preliminary "home page design" will give you a good representation of what your website is going to look like. Once approved, I will begin building the rest of the pages and gather all of the content needed to implement your project. First name Last name Business Name Your Title Email Address Current Website Address (optional) https:// Street Address Address Line 2 (optional) City State Zip / Postal Code Do you have any additional business locations? Yes No Please list the full address for each additional business location. Business Phone Number? Cell Phone Number? Business Opening Date Year Month Day Number Of Employees Hours of Operation Service Area Accepted Payment MethodsWhat payment methods does your business accept for your services/products? (select all that apply) Cash Personal/Business Check Traveler's Checks Visa Invoice Financing Available Mastercard Insurance PayPal American Express ATM / Debit Discover Hosting and Domain Information Do You Already Have A Registered Domain Name? Yes No What Company Is Your Current Domain Name Registered With? Domain Login/Username Domain Login Password Preferred Domain Name #1 Preferred Domain Name #2 Do You Already Have A Website Hosting Service? Yes No What Is The Name of Your Current Hosting Service? Hosting Login Username Hosting Login Password Website Details and Information Preferred Colors (optional) #1 Example Of A Website That You Like https:// #2 Example Of A Website That You Like https:// #3 Example Of A Website That You Like (optional) https:// Tagline (optional) What are your main goals this new website? Please provide a description of your business. What Are the top 5 services that you want to be found for on Google? Please list any additional services or products that you would like to be found for Who are your top 3 competitors? What sets you apart from your competitors? Please describe your ideal customer/client or patient What is your ideal customer/client or patient struggling with? How do you help your your ideal customer/client or patient with their struggles? Is your business locally owned and operated? Yes No What communities/cities do you serve? What are the top 5 communities/cities where you would like to see an increase in online exposure? Does your business have any special awards, distinctions, certifications or qualifications? Any additional information you would like us to know ? What are your top 3 goals for a new website/re-design? Increase brand awareness Increase/generate targeted website traffic Generate more qualified leads Generate new sales Build customer loyalty Get found on Google Increase email subscribers Improve conversion rate Do you currently have ADMIN access to your Google Analytics account? Yes No Do you currently have ADMIN access to your Google Search Console account? Yes No Social Media Accounts Facebook (optional) https:// Instagram (optional) https:// Twitter (optional) https:// LinkedIn (optional) https:// YouTube (optional) https:// Other (optional) https:// Send Save and Complete Later
