Web Design Intake Form

1

Your Name

First Name

Last Name

2

Business Name

Name

Slogan/Tagline

3

Business Email

example@example.com

4

Business Phone Number

Please enter a valid phone number.

5

Appointment (Optional)Select a date for a quick Zoom consult to go over project alignment and needs. Confirmation of appointment will be received after availability has been verified. If you don't see a date or time that works for you, please reach out.

6

Website Type* This field is required.What type of website are we building

Full E-Commerce Website (Online Store)

Booking/ Service- Based Website

Information Website

Not sure yet

7

Briefly describe your business and what you plan to sell or offer.* This field is required.

8

Do you already own a domain name? If yes, list it here.

9

Package Inclusion Acknowledgment* This field is required.

My package includes 1 year of domain registration

My package includes 1 month of website platform fees

I understand domain and platform subscriptions renew separately after the included price

10

Agreement & Acknowledgement* This field is required.

I understand a 50% deposit is required before work begins

I understand this is a custom digital service and ongoing maintenance is optional

11

Are there any websites you like the look or layout of? Please paste links if so.

12

Do you have website content already written? (About, product, descriptions, etc.)?

Yes, everything is ready

Some content is ready

No, I'll need guidance.

Type option 4

13

What's most important to you right now?

Getting online quickly

Looking polished and branded

Learning how to manage the site myself

A balance of all three

14

Would you like info on optional monthly website maintenance after launch?

Yes, please send details

Maybe later

No, I'm comfortable managing it myself.

15

Is there anything about websites or technology that makes you nervous or unsure?

16

Signature

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