1. Organization type *
ABA therapyMental / behavioral healthSpeech, occupational or physical therapyPrimary care / family medicinePediatricsSpecialty practiceUrgent care / walk-in clinicSurgical / ambulatory centerImaging / diagnostic centerMedical laboratoryDental / orthodonticHome health / hospiceTelehealth / virtual careHospital / multi-site systemMedical spa / aestheticsOther

2. Services by revenue priority; mark the one to grow *

3. Ideal patient / client

Infants / toddlers 0–4Children 5–12Teens 13–17Adults 18–44Adults 45–64Seniors 65+

PatientParent / guardianAdult child / caregiverReferring physicianCase manager / schoolEmployer / payer

Commercial insuranceMedicaidMedicareSelf-pay / cashWorkers compensationSchool district / state funded

4. Service area and expansion *

5. Top 3 competitors + URLs *

6. Goals for the next 12 months

More patient inquiriesGrow a service lineLook more credibleRank higher locallyImprove reviewsAttract referral partnersRecruit clinical staffLaunch a new locationImprove payer / referral mix

Under $1,000$1,000–$2,500$2,500–$5,000$5,000–$10,000Over $10,000Not decided

7. Logo status *New logoModernize current logoKeep current logoShow us options

Vector files: AI / EPS / SVGJPG / PNG onlyNo filesNot applicable

8. Brand feel — choose up to five *TrustworthyWarmClinical / precisePremiumApproachableInnovativeFamily-focusedCalm / reassuringEnergeticCompassionateAuthoritativePlayfulEstablished / traditionalModern / minimalCommunity-rootedTechnology-driven

9. Color preferences *BlueTeal / turquoiseGreenPurpleNavy / goldWarm neutralsOrange / coralRedPinkBlack / white / grayBright multicolorNo preference

10. Logo style and lettering

WordmarkMonogram / initialsIcon + nameEmblem / badgeAbstract symbolOpen to recommendations

Modern sans serifClassic serifRounded / friendlyScript accentBold / condensed

11. Brands / logos you like

Website / faviconSocial profilesBusiness cards / letterheadOffice signageScrubs / polosVehicle wrapBrochures / formsPromotional itemsTrade show banners

12. Current website and access *

Yes, we have loginsFormer vendor holds themWe do not knowNo website yet

13. Main visitor action *Call the officeBook onlineSubmit a formVerify insuranceStart live chatGet directions / hours

Download formsRefer a patientApply for a jobPatient portalPay a billJoin email list

14. Required pagesHomeAbout / storyService pagesProvider biosLocation pagesInsurance acceptedNew patient info / formsConditions treatedFAQBlog / educationTestimonialsCareersContactSecond language

DMM writes allWe draft; DMM editsWe provide final copy

15. Integrations and features *Online schedulingEHR / EMRPatient portalHIPAA intake formsInsurance verificationOnline bill payLive chat / chatbotTelehealthCall trackingCRMGoogle reviewsGoogle MapsJob applicationsEmail marketing

WCAG 2.1 AAEnhanced access needsSpecific legal requirementNot sure; advise us

16. Websites you like and what to avoid

17. Patient search phrases *

18. Google Business Profile & directories *

Claimed + verified; access availableClaimed; access lostNot claimedNot sure

HealthgradesZocdocPsychology TodayVitals / WebMDYelpApple / Bing MapsInsurance directoriesCondition directoriesChamber of Commerce

19. Existing digital accounts *Google AnalyticsSearch ConsoleGoogle AdsMeta Business ManagerGoogle Tag ManagerEmail platformCRMNone

20. Insurance, credentials & affiliations *

21. Social platforms and access *FacebookInstagramLinkedInTikTokYouTubeXPinterestNextdoor

DailyFew times a weekFew times a monthRarely / never

22. Content plan

Patient educationCondition awarenessMeet the teamBehind the scenesPatient stories, with consentFAQsInsurance / cost explainersCommunity eventsRecruitingPromotionsTechnology / equipmentAwareness campaigns

Static graphicsCarouselsReels / vertical videoYouTube videosInfographicsBlog articlesEmail newslettersPrinted flyers

2–3 posts / week4–5 posts / weekDailyRecommend for our budget

23. Production resources *

Several staff availableOne or two onlyNo; graphics / stock onlyUndecided

Office photosStaff headshotsPhone photos / clipsExisting videoBrand guidePrinted brochuresNothing usable yet

Formal / clinicalProfessional / conversationalWarm / casualBold / direct

24. Approval workflow *

Yes, requiredNo patient data sharedNot sure; advise us

25. Patient imagery and advertising *

Signed releases on fileNeed a release templateSome; confirm case by case

Real patient photos, with consentWritten testimonialsVideo testimonialsBefore / after imagesStaff photosFacility photosStock only

Anything else?