Web Design Intake Form
Fill out the form to give us some insight * = required
Name
*
First Name
Last Name
E-mail
*
Phone
Company Name
Will you be needing hosting for your website?
*
Please Select
Yes
No
Domain Name
*
Type of service needed for your website
*
Please Select
Redesign and/or modify a template
Design a new website from scratch
Name of template downloaded
Main color theme of your website
Please Select
Red
Purple
Green
Blue
Yellow
Orange
Gray
Black
White
Do you have a logo?
Please Select
Yes
No
Do you have any pictures to put on your website?
Please Select
No. I don't have any pictures to put on my site.
Yes. I have 5 or less pictures to put on my site.
Yes. I have between 5 and 10 pictures to put on my site.
Yes. I have more than 10 pictures (between 10 and 20) to put on my site.
Yes. I have more than 20 pictures to put on my site.
What type of products / services do you offer?
*
Describe your target market
*
Who do you sell your products/services to?
Keywords (Please use commas (,) to separate key words and phrases)
What search engine keywords do you want your visitors to use to find your site?
Website Menu and Pages
Home
About
Services / Product
Contact Us
Need others pages as well
Home Page Content
Enter any content you want to be on this specific page
About Page Content
Enter any content you want to be on this specific page
Services / Product Page Content
Enter any content you want to be on this specific page
Contact Us Page Content
Enter any content you want to be on this specific page
Other Pages Content
Please name the pages and provide the content you want to be on these pages
Special Instructions
Any further information that can help us design a website to your preferences
Additional Services
Website Training and/or Support
SEO Services
Landing Page Design
Branding/Logo Design
Banner Design
Online Ads
Email Marketing
Admin Support Services
Analytics/Data Analysis
Facebook Biz Page Setup/Design
Twitter Design and Set up
Video Creation/Editing
LinkedIn Optimization
Instagram Set up
TikTok Set up
Will you be needing a payment gateway for your site?
Please Select
Yes
No
Are you planning to schedule appointments through your site?
Please Select
Yes
No
Upload any files (such as logo, images, marketing materials or catalogs, etc.) that might be helpful to your website design
Upload a File
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