Client Intake Form

Company Name*
Website*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Admin Contact Information
Please provide the contact information for the marketing manager or person handling communications for the account.
Name
First Last
Phone*
Email*

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Website Access
We'll need access to your website to begin our on-page SEO work.
What kind of site do you have?*
Other
Don't sweat it - we'll take a look later.
Do you have direct access to your site to make edits or changes?
- Yes
- No
- Not Sure - Need to ask someone
Ok, we'll need to track this down later.
Login Url
Admin Username
Admin Password
Additional Information/Notes
Please list any information we'll need (such as the URL to login) to login successfully. Also, include any additional websites and logins (IF ANY).
Are we transferring your site, taking over hosting, or redesiging your site?
- Yes
- No
- No - but I'm interested - tell me more!
Okay great! We'll get in touch with you about this.

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Web Host Information
In most instances we won't need access to your host - but if you have this information on hand go ahead and put it in here just in case. Otherwise skip it.
Hosting Provider
Hosting Username
Hosting Password
Additional Website Information
If you have additional websites, please include login information here. Or, if you'd rather provide FTP access to your site, this is the place to put it.
Domain Name Registrar
This is where your domain name is registered and is the company that you paid to get your domain name in the first place, i.e., GoDaddy, Bluehost, enom, etc. We can create a demo site for you without this info - but when it comes time to launch your new site we have to have this information.
Registrar Name
Registrar Username
Registrar Password
Email Set Up
We need to know how you're handling business emails to ensure we don't interrupt email service during or after a transfer.
Check All That Apply
- I have and use a company email like XYZ@yourdomain.com
- I use a generic provider such as gmail or outlook like mybiz@yahoo.com
Okay, where is your email managed?

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Social Media Access
At the very least we need access to your Facebook and Twitter accounts to sync them and manage reviews.
Facebook Page URL
Facebook Username
Facebook Password
Google + Business Listing URL
Google My Business Username
Google My Business Password
Twitter Page URL
Twitter Username
Twitter Password
Additional Social Media Accounts and Notes
Please list the URLS and logins of any other social media accounts you'd like for us to manage. Also, please let us know about any problems we may have accessing any of these accounts.

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Admin Contact Information