Website Questionnaire

Please answer all of the questions below. This will provide us with the info we need to start building your website. If you have any questions don’t hesitate to reach out.

About You

Please provide your best contact information below.

Name(Required)

First Last

Email(Required)

Phone(Required)

About Your Business

What is the name of your business?(Required)

Please provide a breakdown of all the products and services that your business offers?(Required)

What address do you want listed on your website?(Required)

Street Address Address Line 2 City ZIP Code

What email address would you like listed on your website?(Required)

What phone number would you like listed on your website?(Required)

Do you have a fax number for your agency?(Required)

Yes

What is your fax number?

This number will be displayed on your website.

What are your office hours?(Required)

List all your team members below (optional)

Name

Title

Phone

Include the team member's name, title, phone number, and agency email address. Click the + button to add more team members.

Please provide links to the social media channels you want listed on your website

Social Media Channel (Ex. Facebook, Instagram, Youtube, etc)

URL

Click the + button to add more team members.

Do you have a logo?

Yes

If you have a logo, upload it here:

Max. file size: 256 MB.

Please provide a high resolution logo with a transparent background.

Website Information

What are your preferred colors you'd like us to use on your website?

What domain are you planning to use for your new website?

If you don't have one, simply enter, I don't have one.

In order to build your website, we will need access to your domain. Complete the fields below.(Required)

Company (where you bought your domain)

Website

Username

Password

Please provide the name of the company you bought your domain from as well as login info to access the domain. (We are looking for the login info for your domain provider, not your website)

Please share any websites you like that we can reference when buildling your new site:

Pictures/Team Photos

Please upload any photos that you would like us to use on your new website here:

File

Max. file size: 256 MB.

Your Comments/Questions