Web Design Questionnaire

Thank you for taking the time to tell us what you want in your website design. You obviously don’t have to answer every question—feel free to bypass questions that you don’t understand or don’t consider relevant. But the more you can tell us now, the more likely we are to create a design that fits your goals.

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Please complete and return this form. Your responses will help us define the initial direction of your website content development, and will help give us a clear understanding of your vision. Client input is the foundation upon which successful brand identities are built. This questionnaire will help you articulate and help us identify the overall goals for the content and design of your practice website.
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Company Name:your full name
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Business Address:your full name
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Business Phone Number:your full name
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Business Email:your full name
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Business Hours:more details
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Please list payment options your business accepts:more details
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Please list all insurance options your business accepts:more details
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Please list all business affiliations you would like to include on the website:more details
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What is your target demographic:more details
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Please describe your practice in a few sentences in your own words:more details
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Someone’s searching the web for your business. What words or phrases will they search for in Google?
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Search Terms:more details
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Tell us the top search term you want your website to rank for:your full name
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What is your practice mission statement, slogan, vision, tag line, or philosophy:
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Comments:more details
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Please check all services your practice provides:
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ServicesCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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Please check any techniques or modalities your provide:
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Manual Adjustment MethodsCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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Instrument MethodsCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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Please check any conditions that you treat:
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Back ProblemsCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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Sports InjuriesCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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Car Accident InjuryCheck all that apply
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Please let us know if there is anything we missed or additional infomation you would like us to know about this area of your practice.more details
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More ConditionsCheck all that apply
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Please let us know if there is anything conditions we missed or additional infomation you would like us to know about this area of your practice.more details
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What conditions and/or treatments do you specialize in and would like to highlight the most (List in order of importance if you would like.)?
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Commentsmore details
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Are there certain patients you want to attract most (examples: car accident injury, hiatal hernia, sports injury etc. List in order of importance if you would like.)?
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Commentsmore details
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Do you have any new patient special offers or discounts (highly recommend)?
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Commentsmore details
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Please give a brief description of the treatment process for a new patient (what to expect):
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Commentsmore details
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Is there anything that you don’t want on your website in terms of content?
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Commentsmore details
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Website Design
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Do you have brand guidelines, logo(s), and brand colors to incorporate into the site
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Comments
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Do you have print materials (such as business cards or brochures) that we need to match?
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Commentsmore details
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What Social Media Channesl does your company currently use:more details
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Please include anything that this questinaire did not cover that you would like to include or any questions or comments you may have.
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Commentsmore details
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