Email Address (Required)

Your Name (Required)

Your Company's Name (Required)

Your Company's Website

Telephone Number (Required)

How did you hear about us?

Business name you currently plan to use for you Google+ Local page (AKA Google Places page) (Required)

Full physical stree address of your location (Required)

If we suggested that you write a few pages of information about your services, would you or someone in your company be willing to write those pages (with our guidance) (Required)YesNo

Has your Google page ever been “suspended” or otherwise penalized, to your knowledge? (Required)YesNo

Has your website ever been penalized by Google? (If you’ve had sudden, dramatic drops in traffic, you probably were penalized.) (Required)YesNo

Do you currently have the ability to make changes to your website whenever you’d like? (Required)YesNo

If we mailed a letter to this exact address, would you be able to receive it easily? (Required)YesNo

How many websites do you use for this business (Required)

What are 1-10 local search terms for which you’d most like to get visible in Google? (Required)

If you had to pick ONE most-important service or local search term to get visible for, what would it be? (Required)

What is the specific city / geographical area you’d like to be visible in, ideally? (Required)

How do you currently attract most of your customers / clients / patients?

Does your site have any page-one “organic” rankings on Google, as far as you know?

Have you ever listed your business on third-party directory sites (e.g. Yelp, Angie’s List, etc.)? If so, who currently has the login info for those sites? (Required)

If we said that you should ask some of your customers / clients / patients to write reviews for you, how willing would you be to ask them? (Required)

Are you currently considering revamping your site or building a new one in the foreseeable future?YesNo