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 ? *
Medical, Auto Repair, Salon, etc.
Field is required!
Primary Phone *
(###-###-####)
Enter Primary Phone ( xxx-xxx-xxxx )
Secondary Phone
(###-###-####)
Enter Phone Number ( xxx-xxx-xxxx )
Email address *
Insert an Email address
Invalid email address!
Company Email address
Invalid email address!
Company Address *
Street, city or province, state and zip code
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 -
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
- Choose one -
Field is required!
2nd contact persons name
Full 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
- select a status -
Field is required!
3rd contact persons name
Full 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
- select a status -
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 -
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
- choose one -
Field is required!
Any existing company colors ? *
  • - choose one -
  • YES, I do
  • NO, I do not. Let\'s discuss it
- choose one -
Field is required!
List your company colors
red, orange, blue, etc.
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
- select a option -
Field is required!
Holiday schedule *
New Years, Valentines Day, 4th of July, etc.
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
- choose one -
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
- choose one -
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
- choose one -
Field is required!
Enter your domain name(s) *
domain 1, domain 2, etc.
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
- select an option -
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 ?
( ie - Home, About Us, Contact Us, etc ... )
Field is required!
Primary background color of website *
  • - select an option -
  • Light / White
  • Dark / Black
  • I do not know. Let\'s discuss.
- select an option -
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.
- select a option -
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.
- select an option -
Field is required!
Any social media accounts ?
Google Reviews, Facebook, Instagram, etc
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.
- select an option -
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.
- select an option -
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.
- select an option -
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.
- select an option -
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.
- select an option -
Field is required!
If yes, in what other language (s) ?
Spanish, French, Korean, etc.
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.
- select an option -
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.
- select an option -
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.
- select an option -
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.
- select an option -
Field is required!

Website Request Form

STEP 5 - Features and Functionality ( continued )

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

Website Request Form

STEP 6 - ALMOST DONE ...

Will you post staff bios on the website ? *
  • - select an option -
  • YES. We will have staff bios on website
  • NO. We will not have staff bios on website
- select an option -
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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