Information Gathering

Practice Name

Primary Contact Name

Role / Title

Email Address

Phone Number

Practice Address

Website URL

Year Established

Number of Locations

Services & Specialties

Dermatology Specialties

Top 5 Most Profitable Services

Top 5 Services You Want to Rank For

Do you offer tele-dermatology?
YesNo

Target Market

Target cities or areas

Patient demographics (optional)

Specific patient groups to attract

Website & Marketing

Who built your website?

Do you have backend access?
YesNo

Website Platform
WordPressWixSquarespaceShopifyCustomNot sure

Are you currently doing SEO?
YesNo

Experience with previous SEO agencies

Google Analytics access email

Google Search Console access email

Social Media

Do you actively post?
YesNo

Instagram URL

Facebook URL

TikTok URL

YouTube URL

LinkedIn URL

Would you like a social media audit?
YesNo

Branding & Content

Do you have brand guidelines?
YesNo

Upload Logo

Upload clinic photos

Do you have before/after galleries?
YesNo

Would you like us to write blog posts?
YesNo

Treatments you want to promote first

Compliance

Do you have patient photo consent forms?
YesNo

Do you have testimonial consent?
YesNo

Do you need help generating compliant content?
YesNo

Any specific compliance restrictions?

Competitors

List top 3 local competitors

What do you like about their websites?

What do you want to do better?

Access (Optional)

WordPress Login (Username)

WordPress Login (Password)

Hosting Login (optional)

Google Business Profile Manager Email

Booking system/CRM used

Goals

Top 3 goals in next 90 days

Traffic or booking priorities

Monthly ads budget (optional)

Anything else you'd like to share?

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