PxP Media Creations Client Intake Form
Please complete this form to request social media, content creation, or brand strategy services with PxP Media Creations.
Name
*
First Name
Last Name
Business Name Or Brand Name (If applicable)
If you do not have a formal business name yet, you may use your personal name.
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
Please Select
Call
Text
Email
Website (If applicable)
Social Media Links
Which best describes your business or brand?
*
Beauty / Wellness
Therapist / Counselor / Coach
Creative / Maker (crafts, art, products)
Service-Based Business
Nonprofit / Ministry
Personal Brand / Influencer
Other
How long have you been operating?
*
Just starting
Less than 1 year
1–2 years
3+ years
Which services are you interested in? (Select all that apply)
*
Social media management
Content creation (reels, posts, flyers)
Content strategy / content calendar
What is your primary goal for the next 90 days?
*
What is your monthly budget for media services?
*
Under $300
$300–$600
$600–$1,000
$1,000+
Which brand assets do you currently have? (Select all that apply)
*
Logo
Brand colors
Fonts
Product or professional photos
None yet
Is your industry regulated or client-confidential?
*
Yes
No
If yes, are there any content limitations I should be aware of?
Are you the final decision-maker for this business or brand?
*
Yes
No
If no, who is the decision-maker?
When are you looking to start?
*
Immediately
Within 30 days
Just gathering information
Submit
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