IHSS & Independent Facilitator Intake Form

IHSS & Independent Facilitator Intake Form - Full Speed Studio LLC

Fill this out and we'll take care of everything from here. Takes about 5 minutes. Built specifically for IHSS providers and Independent Facilitators.
A 50% non-refundable deposit is required to begin your project.
This deposit secures your project slot and covers the initial work involved in planning, designing, and developing your website. It is non-refundable once work has commenced. The remaining balance is due upon project completion and your approval of the final website.
Client and Business Information
Full Name

First NameMiddle NameLast Name
Business Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Business Type, Service Area, and Languages
Type of Business

Other
Service Area
Languages Spoken

Other
Package, Website, and Add-On Selection
Which package are you interested in?

Care Essential — $615-$1,230 Perfect for new IHSS providers and Independent Facilitators just establishing their online presence. Includes: Up to 5 pages (Home, About, Services, Eligibility, Contact), mobile friendly, contact form, Google Maps listing, social media links, basic SEO so families find you locally, SSL security certificate, bilingual ready in English and Spanish. Fast 2 week turnaround.Support Professional — $1,845-$3,690 Perfect for established IHSS providers and IFs who want families to find and trust them easily. Includes: Up to 10 pages, everything in Care, How to Apply page, Eligibility requirements page, Zoom scheduling so families book consultations directly, staff and team page, testimonials from families, resources and FAQ page, advanced SEO to rank higher in IHSS searches, Google Analytics. 3 week turnaround.
What pages do you need?
What is your Calendly link?
Monthly Care Plan
Website build is a one-time fee (see package pricing). After your site is live, an optional annual Care Plan keeps everything running:
• Care — $199/year
• Support — $399/year
• Wellness — $699/year
A non-refundable 50% deposit begins your project. Remaining balance due when you approve your site.
Branding, Notes, and Agreement
What colors or vibe are you going for?
Do you have a logo?
Upload your logo

Cancelof
Additional notes or special requests
Signature
Today's date

MonthDayYear
Date
Additional services such as Zoom scheduling, social media setup, Google Business Profile, and Zoom scheduling are available. We will discuss these options with you during your onboarding call after we receive your form.
All social media setup is done for you. You just review and approve.
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IHSS & Independent Facilitator Intake Form - Full Speed Studio LLC

Client and Business Information

Business Type, Service Area, and Languages

Package, Website, and Add-On Selection

Branding, Notes, and Agreement