ASSISTED LIVING WEBSITE QUESTIONAIRE
Select each section to provide us the information we need to complete your website. Call customer service Toll-Free with questions (888) 910-6370 Ext.2
contact
Your Contact Info
Name of Contact Person (business cards)
*
First Name
Last Name
Company / Organization name:
*
Your Title:
Tagline or Company Slogan:
Email
*
example@example.com
Mobile Number
*
Office Number
Schedule a Tour Number
Address of your business or assisted living home if you have one.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social media
Social Media
Facebook URL
https://facebook.com/yourbusiness
Instagram URL
https://Instagram.com/yourbusiness
Twitter URL
https://twitter.com/yourbusiness
YouTube Channel URL
https://youtube.com/yourbusiness
Other Social Media URLs
Separate URL links with a (,) or (;)
Account Info
Account Set-up Info
Do you need us to buy your domain (i.e. www.yourwebsitename.com)? (Y/N)
*
Yes
No
Do you need us to create your social media accounts? (additional cost may occur)(Y/N)
*
Yes
No
Do you need your site delivered earlier than 30 days from now? If so, what is your deadline for this project?
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Do you need us to handle hosting(where your files are stored)? (Y/N)
*
Yes
No
My site is currently hosted by:
Godaddy
Hostgator
Other
What are your hours of operation?
What days are you open? (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Website Info
Website Structure
I would like the following pages: (check no more than 6 boxes)
*
Home
About Us
Living Options
Services
Contact Us
Blog
Other
Other
Search Engine Optimization
Someone’s searching the web for your business / organization. What words or phrases will they search for in Google?
caregiver, in-home health care, professional care, etc.
Provide at least four (4) phrases or slogans that describe your care
Example: Professional Care You Can Trust
Provide at least three (3) different paragraphs that describe the care you provide to your residents
EXAMPLE OF ONE: Meeting Your Emotional Needs: An elderly person needs to feel safe, remain close to other people and believe that life continues.
Services You Provide
Services You Provide
List all of the in-home services that you provide (pick at least 4):
*
Companionship
Meal Preparation
Housekeeping
Long Term Care
Private rooms
Shopping
Diet Monitoring
Medical Care
Memory Care
Independent Living
Medication Monitoring
Social and Recreational Services
24-hour Emergency Care
Complimentary Transportation
Personal Care
Care Coordination
Other
Email
Email Accounts
How many Email Accounts do you need created
*
Provide the names of the Email Accounts you need created
example@example.com
I agree to allow Excel Media Group to create a Gmail account that all of my email accounts will forward to? [Y/N]
*
Yes
No
Logo
I would like all of my business email accounts created by EMG to forward to this email account.
example@example.com
Logos
Does your company have a logo / established image &branding guidelines (e.g. fonts, color schemes etc)? [Y/N]
*
Yes
No
Do you have a color scheme you would like us to use?
*
Yes
No
Upload your logo here. (if you have one)
Browse Files
Cancel
of
Blogs
Blog Posts
Do you have any blog posts or articles about your assisted living business? [Y/N]
*
Yes
No
Upload your blog/articles here. (if you have one)
Browse Files
Cancel
of
Pictures/Images
Pictures or Images
Do you have any pictures from your assisted living business? [Y/N]
*
Yes
No
Upload your pictures here. (if you have one)
Browse Files
Cancel
of
I don't have any pictures at this time and allow Excel Media Group to use stock images and photos for my website [Y/N]
*
Yes
No
Print Materials That You Have
Do you have print materials (such as business cards or brochures) that we need to match? [Y/N]
*
Yes
No
Upload your print materials. (if you have any)
Browse Files
Cancel
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Your Team
About Your Team
Do you have your medical team already?
*
Yes
No
Will Submit later
Upload a brief resume 2-3 paragraphs of your team members including yourself along with a picture of each team member. (if you have any)
Browse Files
pictures should be labeled with team members name and title (Janedoephysician.jpg)
Cancel
of
Testimonials
Testimonials
Do you have any testimonials that you want on your website
*
Yes
No
Upload testimonials preferably with a picture and name of person. (if you have any)
Browse Files
pictures should be labeled with a name and testimonial (Janedoetestimonial.jpg)
Cancel
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Your Content
Assisted Living Content
Write at least 3 paragraphs telling us about your assisted living business which will become your "About Us" page on your website.
(WHAT DO YOU WANT PEOPLE TO KNOW ABOUT YOUR ASSISTED LIVING FACILTY) EXAMPLE; We are committed to the residents and communities we serve to promote better and healthier lives. We strive to be an industry leader with uncompromising standards measured by defined clinical outcomes, customer service programs and financial sustainability.
Write at least 3 paragraphs telling us "The Main Approach" about your assisted living business.
(TELL US WHAT IS YOUR MISSION OR FOCUS) EXAMPLE: Everything we do is driven by our universal mission: to enhance the lives of ageing adults and their families. The solution for families that need an extra level of care. The place we call home is the place that feels most comfortable and secure. A sense of home can become especially important as we age. Our in-home senior care services help ease the challenges of ageing while encouraging seniors to enjoy the comforts of home.
Write at least 3 paragraphs telling us "What You Offer" at your assisted living facility.
(THE SERVICES YOU PROVIDE) EXAMPLE: Our approach to quality care focuses on a commitment to providing a level of expertise, training, patient service, and monitoring that is difficult to match in our industry. Through more than 20 years of providing innovative solutions that improve health and quality of life for those in need of in-home health services, our Senior Care Center has established itself as one of the most experienced homecare companies in the industry.
Write at least 3 paragraphs telling us "How You Work" at your assisted living facility.
(TELL US WHAT YOU SPECIALIZE IN OR WHAT YOU DO DIFFERENTLY) EXAMPLE: Elderly care, or simply eldercare (also known as aged care), is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long-term care, nursing homes, hospice care, and home care.
Customizations
Help us Customize Your Website
Could you give us the websites of your top 3 competitors?
If you had to pick 3 websites you would love to have, which would they be?
Website Delivery
What will happen once we deliver the site?
Would you like us to update your site or would you like to be responsible for updates?
*
We will update
We want Excel Media Group to do it
How often do you require updates?
*
Daily
Weekly
Monthly
Quarterly
Other
Would you like to book a dedicated training session for your employees to learn to update the site? [Y/N]
*
Yes
No
Help us out here - Who will provide the following resources?
*
Rows
We want EMG to get :
We will provide
Stock photography
Company photography
Other Artwork/ Illustrations
Translation costs
Copywriting text
Professional logo
Graphic design
Other print collateral
Metatags/ description
Font Licenses
Is there anything else you’d like to tell us?
Other Services (CLICK HERE TO SAVE OR SUBMIT)
Other Services You Need
Any other service required apart from web development you would like to discuss with Excel Media Group?
Email Drip Campaign
Social media account creation
Search Engine Optimization
Email Newsletter (Promotional Emails)
Other
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