Let’s Get Your Business Online the Right Way
Thanks for choosing to work together. This form gives me the pieces I need to set up your website and Google presence cleanly.If you’re not sure about something, leave it blank — we’ll sort it out together.Most people finish this in about 3 minutes.
Full Name
First Name
Last Name
Business Name
Business Address (include city and zip for local SEO setup)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Address (include city and zip for local SEO setup)
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Preferred Contact Method
Please Select
Phone
Text
Email
Describe your main services or products.
Say it how you’d explain it to a neighbor. I’ll clean up the wording for the website.
How long have you been in business?
Please Select
Less than 1 year
1–3 years
3–5 years
5+ years
How long have you been in business?
Rough estimate is fine.
Where do you serve customers? (e.g., Grants Pass and the Rogue Valley area)
What makes your business unique?
Company Mission or Tagline
Brand Colors (e.g., Forest green, charcoal gray, gold or HEX codes)
Logo Upload (.jpg, .png, .svg, .pdf)
Upload a File
Drag and drop files here
Choose a file
Upload what you have. If you don’t have it handy, you can text or email it later.
Cancel
of
Upload Any Brand Materials (brochures, flyers, old site screenshots)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Do you have a website already?
Yes, and I can edit it
Yes, but I can’t edit or control it
Yes, but it’s not doing much
No website yet
Please share your current website link (if you have one):
What look are you going for?
Clean & Modern
Rustic & Natural
Bold & Bright
Simple & Professional
Faith-Based or Family-Oriented
What type of project are you interested in?
Website Design
Google Business Profile Setup
Apple Maps Listing
SEO/Local Search Optimization
Website Overhaul
Ongoing Maintenance
Marketing Consultation
What are your top goals for this project?
Timeline or Launch Goal
Please Select
ASAP
Within a month
This quarter
Just exploring options
Budget Range (optional)
Please Select
Under $1,000
$1,000–$2,500
$2,500–$5,000
$5,000+
Upload up to 5 photos that represent your business
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Describe these photos briefly
Upload up to 5 photos that represent your business
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Describe these photos briefly
What values matter most to your business?
Community
Family
Faith
Quality
Honesty
Growth
Creativity
Sustainability
Other
How should your business feel online?
Friendly + local
Professional + clean
Affordable + straightforward
High-end + detailed
Fast + convenient
When are you hoping to get this moving?
Please Select
ASAP
Within 30 days
Just planning ahead
Are you interested in learning to manage your site yourself?
Yes
No
Anything else you’d like us to know?
Send Info & I’ll Take It From Here
🎉 You’re all set — thank you for reaching out to Rogue Media Solutions!
Your submission’s been securely received, and we’ll review it right away. Expect a personalized follow-up within a couple of business days. At RMS, we believe in honesty, simplicity, and community — because every Oregon small business deserves a website and online presence that works as hard as they do. You just took the first step toward measurable growth and real ROI. 🌲
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