Project Enquiry Form

First name*
Last name*
Practice name*
What does your company do? What are the products and services you offer?*
Best contact number*
Website URL*
Which Local MD services are you interested in?*
- GMB Verification
- GMB Optimisation
- Website Speed improvements
- Mobile Friendly Website
- Install SSL certificate
- Website Revamp
- SEO
- Other
Please describe what you need*
On a scale of 1-10, how important is this to you right now?*
What is the biggest challenge for you right now?*
Who are your top 2 competitors in your local area?*
Who are the decision makers for this project?*
What budget have you allocated for this project's?*

Be honest and we'll let you know what we can and can't do
Timeframe: when do you need this project delivered by?*

Note: website projects typically take 8 weeks.
Content: do you have high quality photos and text copy ready?*
Content includes a list of the pages you need, well-written web copy as well as high-quality photos. If you need help with this, please let us know.
What are your main reasons for needing this project?
It's helpful to set goals as it keeps all of us on the same page and moving in the same direction.
With this in mind, what are the top 3 business needs of your new website?
EG: 20% increase in new patients in 6 months, reduce admin costs by 15% in 6 months, receive positive patient feedback about the website
Goal #1*
Goal #2
Goal #3
For websites: is there anything about your current site that serves the business well and if so, why?*
Tell us about your ideal patients. Who are they? How old are they? What gender are they? Where do they hang out online? What are their interests?*
What are the top 5 reasons your ideal patients will visit your website?*
EG: research product information, get contact details, ask questions about services, pricing
How do you want patients to feel when they interact with your practice brand? Safe and secure, optimistic or excited, comfortable and at ease, high quality / premium*
Do your competitors have websites? If so, list them here so we can make sure yours is better*
Tell us about your competitors. Who else is competing for the attention of your ideal patients and what are they doing that you think is working?*
Are there any other websites in particular that you like the design of? Why?*
If we were to be celebrating success in 12 months time, what would that have to look like? How many website visitors? How many enquiries? How many new patient bookings? Be as descriptive as you possibly can.*
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Book a Call*
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- None of those times suit me - can we please chat at (let us know a date and time)
Click here to book a call
Date*
Time*

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Minutes

AM/PM
Your best email address*
Finally: anything else you want to let us know*
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This is your opportunity to share some basic information about your practice, the services you are interested in and your budget. Then we can start the process of figuring out if we can help you. We look forward to receiving your form!

Maz Hancock
Founder, Local MD

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