SEO Client Intake Form

Contact Name *

Address *

City *

State *

Zip Code *

Tel Number *

Fax Number

Your Email *

Website URL *

Business Category *
(i.e. Lawyer, Web Design Company, Dentist, etc.)

Business Description *
(Describe Your Business in 100 Words or Less)

Year Established *

License Number (If applicable)

Hours of Operation *

Number of Employees *

Payment Methods Accepted *
i.e. visa, mastercard, check, cash, insurance, etc

Member of Any Organizations/Affiliations *

Do you have duplicate websites or duplicate content from this website published elsewhere online? *
NoYesDon't Know

Do you have a Google Places listing? *
NoYesDon't Know

Is Google Places listing verified? *
NoYesDon't Know

Do you want to target locally or nationally? *
LocallyNationally

If locally, list priority cities:

Do you have more than one product/service? *
NoYes

If Yes, list in order of priority:

Please provide a well thought out list of the top words or phrases that you believe people are typing into Search Engines to find their website. *
(this will be the basis for our keyword analysis)

List top 3 competitors’ websites: *

Website Access Details

Please provide us with log in details for the control panel of your website:

Please provide us with ftp log in details:

Please provide us with cms (content management system) log in details:

Social Media Posting

Please provide us with Facebook log in details so blog posts are updated:
or Add igerada@gmail.com as an admin roll to your Facebook page

Please provide us with Google+ log in details so blog posts are updated:
or Add igerada@gmail.com as an owner of your google business page