Our Services...

Website Request Form

STEP 1 - Contact Information

First Name *
Field is required!
Last Name *
Field is required!
Company Name *
Field is required!
What is the Nature of your business ? *
Field is required!
Primary Phone *
Enter Primary Phone ( xxx-xxx-xxxx )
Secondary Phone
Enter Phone Number ( xxx-xxx-xxxx )
Email address *
Invalid email address!
Company Email address
Invalid email address!
Company Address *
Field is required!
Best time to contact *
  • - Select a range of time -
  • 9AM to 11AM
  • 11AM to 2PM
  • 2PM to 6PM
  • Any time of day
Select a range of time
Best day(s) to contact *
Field is required!
Any alternative contact persons ?
  • - Choose one -
  • None
  • 1 Alternative contact person
  • 2 Alternative contacts
Field is required!
2nd contact persons name
Field is required!
2nd contact persons phone
Enter Phone ( xxx-xxx-xxxx )
2nd contact persons status
  • - select a status -
  • Co-Owner / Partner
  • Account Billing
  • Representative / Assistant
  • Tech Support
  • Employee / Staff
  • Other
Field is required!
3rd contact persons name
Field is required!
3rd contact persons phone
Enter Phone ( xxx-xxx-xxxx )
3rd contact persons status
  • - select a status -
  • Co-Owner / Partner
  • Account Billing
  • Representative / Assistant
  • Tech Support
  • Employee / Staff
  • Other
Field is required!

Website Request Form

STEP 2

Do you have a logo ?
  • - choose one -
  • YES, I have a logo
  • NO, I need a logo
Choose one
Upload your logo *
Upload image - 3MB Max
Field is required!
What type of logo do you need ?
  • - choose one -
  • I do not know. Let's discuss it
  • A text-based logo
  • A graphic-based logo
Field is required!
Any existing company colors ? *
  • - choose one -
  • YES, I do
  • NO, I do not. Let's discuss it
Field is required!
List your company colors
Field is required!
Hours of operation *
Field is required!
Days of operation *
Field is required!
Are you open on holidays ?
  • - select a option -
  • We are open on ALL holidays
  • We are open on SOME holidays
  • We are NOT open holidays
Field is required!
Holiday schedule *
Field is required!
How many years in business ? *
Field is required!
Are you Incorporated or an LLC ? *
Field is required!
Any business or product photos ? *
  • - choose one -
  • YES. There are photos
  • NO. There are no photos
Field is required!
Do you have a Dropbox account ?
  • - choose one -
  • YES. I have a DropBox account
  • NO. I do not have a DropBox account
Field is required!

Website Request Form

STEP 3

Do you have a domain name ? *
  • - choose one -
  • YES. I have a domain name
  • NO. Please help me get one
Field is required!
Enter your domain name(s) *
Field is required!
Where is the domain registered ? *
Field is required!
Is there an existing website ?
  • - select an option -
  • NO. I need one built
  • YES. Needs to be upgraded or replaced
Field is required!
Where is the current website being hosted ?
Field is required!
Do you have login to your web hosting ? *
Field is required!
What is the current budget for this project ? *

Field is required!
IMPORTANT NOTE :

Cost will never ever determine the amount of personal care that we invest into your project.

Your estimated budget just gives us a ballpark idea or scope as to how we may effectively assess whether certain functions, graphics, or which services can or will be used when building your website.

We will still discuss in-person with you a "Project Summary Proposal", and whether a payment plan may or may not be necessary.





Website Request Form

STEP 4

What will be the names of each page on your website navigation menu ?
Field is required!
Primary background color of website *
  • - select a option -
  • Light / White
  • Dark / Black
  • I do not know. Let\'s discuss.
Field is required!
Accent ( secondary ) colors of website *
  • Red
  • Red
  • Orange
  • Yellow
  • Green
  • Blue
  • Purple
  • Pink
  • Brown
  • Grey
  • Black
  • White
  • I do not know. Let's discuss it.
Field is required!

Features and Functionality

Testimonials / Reviews page ? *
  • YES. I want a testimonials page
  • YES. I want a testimonials page
  • NO. I do not want a testimonials page
  • I do not know. Let\'s discuss it.
Field is required!
Any social media accounts ?
Field is required!
Upcoming Events calendar ? *
  • YES. I want an events calendar
  • YES. I want an events calendar
  • NO. I do not want an events calendar
  • I do not know. Let\'s discuss it.
Field is required!
Online Booking Service / Cater System ? *
  • - select an option -
  • YES. I want a Booking System
  • NO. I do not want a Booking System
  • I do not know. Let\\\'s discuss it.
Field is required!
Premium content copyright protection ? *
  • - select an option -
  • YES. I want Premium copyright protection
  • NO. I do not want Premium copyright protection
  • I do not know. Let\'s discuss it.
Field is required!
Pop-Up Ad Message feature ? *
  • - select an option -
  • YES. I want Pop-Up Ad Messages
  • NO. I do not want Pop-Up Ad Messages
  • I do not know. Let\'s discuss it.
Field is required!
"Language Translation" feature ? *
  • - select an option -
  • YES. I want Language Translation
  • NO. I do not want Language Translation
  • I do not know. Let's discuss it.
Field is required!
If yes, in what other language (s) ?
Field is required!
Terms and Conditions page ? *
  • - select an option -
  • YES. I want a Terms & Conditions page
  • NO. I do not want a a Terms & Conditions page
  • I do not know. Let\'s discuss it.
Field is required!
Copywriting / Content Writing ? *
  • - select an option -
  • YES. I want Copywriting / Content Writing
  • NO. I do not want Copywriting / Content Writing
  • I do not know. Let\'s discuss it.
Field is required!
Custom designed flyers or brochures ? *
  • - select an option -
  • YES. I want flyers or brochures
  • NO. I do not want flyers or brochures
  • I do not know. Let\'s discuss it.
Field is required!
Custom designed business cards ? *
  • - select an option -
  • YES. I want business cards
  • NO. I do not want business cards
  • I do not know. Let\'s discuss it.
Field is required!

Website Request Form

STEP 5 - Features and Functionality ( continued )

Video Library page ? *
  • - select a option -
  • YES. I need a Video Library page
  • NO. I do not need a Video Library
  • I do not know. Let\'s discuss it.
Field is required!
A Membership System ? *
  • - select a option -
  • YES. I need a Membership System
  • NO. I do not need a Membership System
  • I do not know. Let\'s discuss it.
Field is required!
Receive payments online ? *
  • - select a option -
  • YES. I need to get Payments Online
  • NO. I do not need Payments Online
  • I do not know. Let\'s discuss it.
Field is required!
Do you have a Company Email ? *
  • - select a option -
  • YES. I already have a Business Email
  • NO. I do not have a Business Email
Field is required!
Ability to Upload / Download Files ? *
  • - select a option -
  • YES. Visitors can upload their files
  • YES. Visitors can download digital files
  • YES. Visitors will download & upload
  • NO. Do not need download & upload
  • I do not know. Let\'s discuss it.
Field is required!
Need HIPAA Secure Email ? *
  • - select a option -
  • YES. I need HIPAA Secure Email
  • NO. I do not need HIPAA Secure Email
  • I do not know. Let\'s discuss it.
Field is required!
Any Blog Articles to post ? *
  • - select a option -
  • YES. I need to Post Articles on website
  • NO. There will be no articles for website
  • I do not know. Let\'s discuss it.
Field is required!
Website Ranking / Marketing ( SEO ) ? *
  • - select a option -
  • YES. I need SEO Ranking & Marketing
  • NO. I don\'t need SEO Ranking & Marketing
  • I do not know. Let\'s discuss it.
Field is required!
Customer Relations Mgmt System ? *
  • YES. I need a CRM System
  • YES. I need a CRM System
  • NO. I do not need a CRM System
  • I do not know. Let\'s discuss it.
Field is required!
Live chat support system ? *
  • - select a option -
  • YES. I need a live chat support system
  • NO. I do not need live chat support
  • I do not know. Let\'s discuss it.
Field is required!
Sell digital downloads ? *
  • - select a option -
  • YES. I will sell digital downloads
  • NO. I will not sell digital downloads
  • I do not know. Let\'s discuss it.
Field is required!
E-Commerce - Sell Products or Services ?
  • - select a option -
  • YES. I need an E-Commerce / Online Store
  • NO. I do not need E-Commerce
  • I do not know. Let\'s discuss it.
Field is required!
Will sell product, services or both ? *
Field is required!
Are Products or Services customized ? *
  • - select a option -
  • YES. Orders will be customizable
  • NO. Orders will not be customizable
  • I do not know. Let\'s discuss it.
Field is required!

Website Request Form

STEP 6 - ALMOST DONE ...

Will you post staff bios on the website ? *
  • - select a option -
  • YES. We will have staff bios on website
  • NO. We will not have staff bios on website
Field is required!
What do you NOT like about your current website ?
Field is required!
What objectives or hurdles are you wanting to accomplish with your NEW website ?
Field is required!


These are all the inquiries and questions that we have at this present time.

We look forward to delivering you a stellar website presence in a timely manner.

Please feel free to contact us by phone, text or email with any other questions.






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