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Website Planner
Please Complete the Form Below to Provide the Information we require
1
Contact Info
2
Your Business
3
The Website
4
Domain & Logins
5
Our Commitment
6
Company Details
Practice Name
*
Contact Name
*
Address
Street Address
Address Line 2
City
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
What are the primary towns/areas do you serve?
Email Address
*
This email address will be used for website contact form submissions. When an inquiry comes via the website, it will be forwarded to this email address.
Phone Number
*
Practice Details
Brief Description of Your Practice
*
What exactly do you do? How long have you been in business, how many employees do you have, etc?
What are the most popular products/services you offer?
Why would someone choose your practice over a competitors?
*
Who are the groups of customers you'd like to reach online? Please segment these groups if there is more than one.
*
Who are your competitors? Please include 3 with web addresses if known. We can learn a lot from their successes and challenges.
*
How do you plan on converting customers? Submitting an enquiry, booking online or otherwise?
*
If unknown , leave blank and we will provide our input.
Do you want to display your team?
Yes
No
Opening Hours
Do you have any testimonials? We'd recommend using them. Please add them here if so.
Your Website
What look and feel would you like for your website? E.g. fresh, fun and functional, modern, elegant, artistic, professional, conservative, sophisticated, funky, juvenile, kids/baby, traditional, natural/earthy etc.
Interesting websites you like. Please list some websites or features of websites you like, and briefly state why.
Do you want to include a blog?
First Choice
Second Choice
Third Choice
Do you want to display the ICSP Logo?
Yes
No
Is there anything you would like to add about your new website requirements?
Email Marketing
Would you like us to include a subscriber opt-in box in the design so you can use email marketing to market to your clients?
Yes
No
If so, please provide login details to your email marketing software of choice (eg. Mailchimp, ActiveCampaign, CampaignMonitor)
If you don't have one, Mailchimp is our recommendation. Set up an account
here
and provide your login details above.
Branding Details
Please supply any other images, content or assets we'll need. You can paste a dropbox or any other file sharing link here, or share by email.
We'll come back to get detailed content later if necessary.
Upload your logo file/s here.
Drop files here or
Select files
Max. file size: 512 MB.
What are your business colours? If you have your colour codes (eg. #3a6ee8) provide them here.
Do you have a registered domain name?
Yes
No
Please Provide Your Domain account login details (eg. Blacknight, GoDaddy, Register365, Letshost)
If your domain name is registered in the same account as any web hosting details already provided, please note this above.
What fonts do you use for marketing material?
Which Social Networks do you want to show on your website?
Facebook
Instagram
Twitter
Linkedin
Youtube
Other
Facebook Link
Twitter Link
Instagram Link
Youtube Link
Contact Details to Display on the Footer/Contact Page
Agreement
*
I agree with the DigitalPractice Website Development & Maintenance
Terms of Service
I agree with the storage and handling of this data for matters specifically related to the provision of website development services. For further details please click here.
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