RSImstronboardform | RSIRSI

RSImstronboardform

Client Number
Sales Person
Contract Start Date
MM slash DD slash YYYY
Core Products
Add-On Products/Services
Contract End Date
MM slash DD slash YYYY
- Website Development (if selected must choose one below)
- Premium Package (NEW DEV)
- Pro Package (TEMPLATE)
- Essential Package (TAKEOVER)
- Patient Scheduling Pkg (if selected must choose one below)
- (NPS) New Patient Scheduling (lead mgt, new patient only)
- (RPS) Rollover Patient Scheduling (call overflow scheduling only)
- ROI Software (if selected must choose one below)
- (Pkg A) Analytics Only
- (Pkg B) Analytics and Lead Mgmt)
Add-On Products/Services
- Social Media Pkg (Blog, soc postings only)
- Online Reputation Mgmt. Pkg (24/7 rep monitor, notification,rep)
- Retention Suite Pkg (Survey, Appt. Reminders, ORM, LCM)
- PPC Marketing Pkg (media plan/campaign mgmt./reporting)
- Creative & SEO Pkg
- Premium Package (5hr - 2 creative, 1 event)
- Essential Package (5hr - 1 creative)
- Value Package (2hr – edits only)
CLIENT LOCATION AND CONTACT INFORMATION
Business Name:
Industry/Specialty:
Does client require Lead Management services?
- Yes
- No
Is the PMR/EMR cloud or server based?
- Server
- Cloud
PMR/EMR system is used for Scheduling ?
PMR/EMR system is used for Revenue?
Business Owner(s) Name:
Title:
Direct Phone:
Mobile Phone:
Email:
Business Owner(s) Name:
Title:
Direct Phone:
Mobile Phone:
Email:
Is this a multi-provider business?
- Yes
- No
Total Physicians:
If yes, please list all other providers:
Specialty:
Key Staff Contacts / Launch Call Contact
IT Technical Contact Name:
Title:
Phone:
Email
Office Mgr/Project Lead Name:
Title:
Phone:
Email
Business Location(s)
List all location addresses below:
How many locations does the client have?
Street Address
City
State
Zip
Service Area: ( ex. Atlanta, Buckhead, Marietta)
Office Hour:
HH
MM
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To
HH
MM
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Days:
- M
- T
- W
- T
- F
- S
- S
Street Address
City
State
Zip
Service Area: ( ex. Atlanta, Buckhead, Marietta)
Office Hour:
HH
MM
Untitled
To
HH
MM
Untitled
Days:
- M
- T
- W
- T
- F
- S
- S
Street Address
City
State
Zip
Service Area: ( ex. Atlanta, Buckhead, Marietta)
HH
MM
Untitled
To
HH
MM
Untitled
Days:
- M
- T
- W
- T
- F
- S
- S
Cities to include for website optimization: (Within 10 Miles Of Office)
Untitled
Untitled
Untitled
Untitled
Website Technical Information
Number of websites to build for client:
If more than 1 please list URL and explain reason(s) for additional sites:
URL:
Reason:
List Domain(s) that we will be hosting:
Current Domain Authority:
Current Domain Speed:
Current Domain Authority:
Current Domain Speed:
New domain required?
- Yes
- No
URL of new domain to be created/hosted:
List additional URLs or Websites that the business has:
Foreign Language required for any sites?
- Yes
- No
Select Language(s) required
Current Web Hosting
Company Name
Contact Name
Log-In
Email
Password
Phone
New Client Creative Onboarding Form
Creative
1. What is your current website URL?
2. What is your current tagline?
3. What is your unique selling proposition? (Ex: multiple locations, years of experience, area of expertise, price, etc.)
4. Is the logo on your live website the most up-to-date version?
- Yes
- No
5.List credentials, certifications or memberships you want to be promoted on the website. (Ex: Board certifications, AMA, etc.)
6. Do you like current color scheme of your website?
- Yes
- No
7. If no, what are your color preferences?
8.If any, what colors should we avoid?
9. List features you LIKE about your current site, including elements you want to maintain in the new design. (Ex: certain sections, pictures, bio information, etc.)
10. List 3 website URLs you would like us to reference for design inspiration.
What did You like About the site?
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2
3
11.List features you DO NOT LIKE about your current website.
12.What is the preferred age range of the models in your website photography? (Ex: young adults, middle age, seniors, etc.)
13. List any ethnic considerations when choosing images/models? (Check all that apply)
- White
- Middle East
- Black
- Native American
- Asian
- Mixed / Multiple Ethnic Group
- Hispanic
- All
14.What types of images do you prefer? (Check all that apply.)
- Fashion Models
- Swimsuit Models
- Lingerie Models
- Fitness Models
- Mature Models
- Lifestyle
Other
15. What types of images should we avoid? (Check all that apply.)
- Fashion Models
- Swimsuit Models
- Lingerie Models
- Fitness Models
- Mature Models
- Lifestyle
Other
16. Are there types of images you like or dislike?
(Ex: natural looking models, high-end fashion shots, glamour models, a variety of attractive women and men, etc.)
17. Promoting top procedures on buttons and callouts is key to driving awareness and leads. List 4 procedures/products you would like to feature
17. Promoting top procedures on buttons and callouts is key to driving awareness and leads. List 4 procedures/products you would like to feature:
1
2
3
4
18. Large banner rotators on the homepage are critical to promoting procedures, sharing offers, and generating inquiries. What products or services would you like to promote on the banner rotators? Do you want to promote a physician(s) on rotator?
19. Should we include the following elements in the design?
Before & After Pictures (Gallery)
- Yes
- No
Financing Information
- Yes
- No
Testimonials / Reviews
- Yes
- No
Free Consultations
- Yes
- No
Other
Patient and Services Target Market Information
Age Range:
Gender
- Male
- Female
- Both
Ethnicity Targets: (Check all that apply.)
- White
- Middle East
- Black
- Native American
- Asian
- Mixed / Multiple Ethnic Group
- Hispanic
- All
List your “core” services. (Ex: rhinoplasty, Botox, breast augmentation, Invisalign, etc.)
List the services you provide with the highest profit margin.
Please share any new services or planned new services that need to be marketed.
RED-SPOT Client Information Packet
Customer Satisfaction Surveys: List name of people who will receive the surveys
Email Addresses
First Name
Last Name
Email
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3
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Current Traditional Marketing Partners (Print, Radio, Television)
Present Materials (select all that apply)
Brochures
Print Materials
Advertisements
Email Blasts & Database
1. Company
Contact
Email
Phone
Advertising Dates
MM slash DD slash YYYY
Advertising Cost
MM slash DD slash YYYY
2. Company
Contact
Email
Phone
Advertising Dates
MM slash DD slash YYYY
Advertising Cost
MM slash DD slash YYYY
3. Company
Contact
Email
Phone
Advertising Dates
MM slash DD slash YYYY
Advertising Cost
MM slash DD slash YYYY
4. Company
Contact
Email
Phone
Advertising Dates
MM slash DD slash YYYY
Advertising Cost
MM slash DD slash YYYY
4. Company
Contact
Email
Phone
Advertising Dates
MM slash DD slash YYYY
Advertising Cost
MM slash DD slash YYYY
Current Online Marketing Partners (google,yahoo,etc.)
1. Website
Email
Phone
Subscription Dates
MM slash DD slash YYYY
Subscription Cost
2. Website
Email
Phone
Subscription Dates
MM slash DD slash YYYY
Subscription Cost
3. Website
Email
Phone
Subscription Dates
MM slash DD slash YYYY
Subscription Cost
4. Website
Phone
Email
Subscription Dates
MM slash DD slash YYYY
Subscription Cost
5. Website
Email
Phone
Subscription Dates
MM slash DD slash YYYY
Subscription Cost
LOCAL SUBMISSIONS
GOOGLE LOCAL
Login
Password:-
BING LOCAL
Login
Password:-
YAHOO LOCAL
Login
Password:-
List other local submission websites used in the past? (ex: Yelp.com, FourSquare.com, etc.)
SOCIAL MEDIA: FACEBOOK, TWITTER DETAILS
Facebook
Login
Password
Twitter
Login
Password
YouTube
Login
Password
Instagram
Login
Password

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