Pay Per Click (PPC) Intake Form
Business Name
*
Project Contact Email
*
example@example.com
Direct Phone Number For Practice
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address to Send Forms
*
Any form submissions will be sent to this email
Do you already have a Google Ads account set up?
Yes
No
Unsure
Ads Monthly Budget
*
Dollar value spend on a monthly basis
Ad Account Email Address
*
This will be the email address that has access to your ads account
List Business Hours
*
What mile radius around your practice would you like to target?
*
We usually recommend 5-10 miles based on population data
We always set up "General" ads targeting the high volume search terms like "service near me". However, are there any additional, more specific services you would like us to focus on driving more appointments for?
*
What goals/expectations do you have/want to get from the ads?
*
Comments/Additional Notes
Photos/Logos: We will be adding photos of your team and practice to the landing page.
Logo (transparent background)
Doctor Photos
Office Photos
Team Photos
Browse Files
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