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Web Design Questionnaire
This form is meant to compile information from you that we will need
to begin the web design process. Please do not feel overwhelmed. We just want to gather as much information as we can.
Web Design Questionnaire
Primary Contact
First Name
Last Name
Phone Number
Email
Contact Info for Website
Company Name
Address
City, State
ZIP
Email Address to direct website inquiries
Company Hours
Phone Number
Domain Information
What domain are we using for the website?
Domain Registrar Link
Login/Username for Registrar
Password
Existing Website (If Applicable)
CURRENT WEBSITE Address
Will we be hosting your new site?
Yes
No
Hosting Company:
If we will NOT be hosting the new site, will the hosting remain the same as current hosting?
Yes
No
LOGIN USERNAME FOR YOUR CURRENT HOSTING
PASSWORD
IF APPLICABLE, LOGIN / USERNAME FOR YOUR NEW HOSTING
IF APPLICABLE, PASSWORD FOR NEW HOST
Branding
BUSINESS / NICHE
Do you have a logo and color scheme that you want to use?
Yes. I will provide.
No. I need help with this.
TAGLINE / MOTTO
Please Provide URLs For Your Social Media Accounts.
FACEBOOK
TWITTER
LINKED IN
PINTEREST
INSTAGRAM
SNAPCHAT
YOUTUBE
OTHERS: (BUZZFEED, REDDIT)
Site Specifics
Check all that you want to have on your site:
Contact forms
Map
Team Bios Pages
Client or Patient Login
Client Testimonials/Quotes
Video
Shopping Cart with Less Than 50 Products
Shopping Cart with More Than 50 Products
Submit 2-3 sites that you like design-wise. *
Please list all products and services you offer:
Please list any qualities or assets that are valuable or set you apart from the competition:
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