Website Build Intake | Adode Media

Section 1

Practice Details

This information will be published on your website so prospective patients can find, contact, and visit your practice. Please confirm that every detail is accurate as you would like it to appear.

Practice Name *

Exactly as it should appear on the website.

Please enter your practice name.

Primary Contact Name *

The person we should coordinate this project with.

Please enter the primary contact name.

Contact Email *

Please enter a valid email address.

Public Phone Number *

The number patients should call. This will be displayed on the site.

Please enter the phone number to display on the site.

Practice Address *

Full street address as it should appear on the site and in Google Maps.

Please enter your practice address.

Public Contact Email

If patients should reach you at an email different from the one above, enter it here.

Business Hours

List your hours as they should be published.

Current Website Address

Section 2

Hosting & Platform

Your site is built as code and then deployed to your hosting platform. Please identify your current platform so we can plan the deployment. Login credentials will be requested separately through a secure channel.

Where is your website currently hosted or built? *

Please choose a platform.

If you selected "Other," please provide any details you have

Who currently manages your domain name?

Section 3

Branding & Fonts

Your logo is required. We also need either your brand colors or a brand style guide so that your website matches your established identity.

Please note: All files should be high-resolution. Logos are best provided as a PNG with a transparent background, SVG, or vector file (AI or EPS). The total upload limit is 8MB per submission. If your files exceed this, select the option below and we will provide a secure upload link.

Logo *

High-resolution PNG, SVG, or vector file preferred.

My logo files exceed the upload limit or are not yet available. I will submit them using the secure link your team provides.

Please upload a logo or check the box to send it separately.

One of the two fields below is required. Please either upload your brand style guide or provide your brand colors. You do not need both, and a style guide is not required if you simply list your colors.

Brand style guide

Upload your guide if available (PDF preferred). This typically documents your colors, fonts, and usage standards.

Brand colors

Provide your HEX codes or a brief description (for example, "navy and orange").

Please provide one of the above: upload a brand style guide or list your brand colors.

Regarding the fonts used in your website preview:

We approve the current fonts We have a specific brand font we would like used (specify below)

If you have a specific brand font, please name it

Section 4

Photos & Images

Authentic photography builds significantly more trust with prospective patients than stock imagery. Please upload at least one high-resolution image. Provide only the categories that apply to your practice.

Recommended images (high-resolution):
• A professional photograph of the provider
• Photographs of your team or staff, if applicable
• Photographs of your practice and office, interior and exterior
• Photographs of your services or equipment in use

Photographs *

You may select multiple files. At least one image is required.

My photographs exceed the upload limit. I will submit them using the secure link your team provides.

Please upload at least one photo or check the box to send them separately.

Which categories of photographs are you providing?

Provider Team or staff Practice and office Services or equipment We do not have suitable photographs and would like to discuss arranging professional photography

Notes regarding your images

Section 5

Website Copy & Messaging

The copy in your preview was drafted from publicly available information. Please review it for accuracy and provide any corrections or additions in your own voice. These fields are optional; complete those most relevant to your practice.

Are there any inaccuracies in the current website copy that require correction?

In one or two sentences, what distinguishes your practice from others in your area?

What is the primary action you want website visitors to take?

Call the practice Book an appointment online Complete a contact form Visit the practice in person Other (specify below)

Which services should be highlighted on your website?

Preferred tone of voice for your website

Warm and personable Professional and authoritative Approachable and reassuring Premium and refined

Section 6

Frequently Asked Questions

The questions prospective patients ask before scheduling are valuable for both your website and your search visibility. Please list the questions you receive most frequently.

What questions do patients ask most frequently?

Please list one question per line, and include answers where available.

Are there topics you find yourself explaining frequently that should be addressed on the site?

Section 7

Articles, Downloads & Videos

Additional content positions your website as a trusted resource and improves your visibility on Google and YouTube. Please indicate what you would like to make available.

Article or blog topics you would like featured

Topics your patients search for, or that demonstrate your expertise.

Downloadable resources to offer visitors

These are effective for capturing patient inquiries. Upload a draft if available.

Upload any existing documents or resources

Do you have video content for the website?

Yes, the links are provided below (YouTube or Vimeo) No, and we would like to discuss producing video content No video content at this time

Video links

Section 8

Additional Information

This is the final section. Please share any remaining details that will help us complete your website to your standards.

What challenges do prospective patients commonly experience before finding your practice?

Are there other practice websites you find effective or wish to avoid emulating?

Any additional notes for our team

What is your preferred timeline for launch?

Thank You!

Your submission has been received. We appreciate the opportunity to finalize and launch your website.

What happens next

1. Our team will review everything you've shared.

2. We'll follow up within 48 business hours if we have any questions or need additional files.

3. From there, we'll make your updates and prepare your site for launch.

Have a question in the meantime? Email us anytime at support@adodemedia.com.