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INDUSTRIES
PLANS
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New Client Intake Form
New Client Intake Form
Stefanie McKellar
2021-09-19T22:50:27-07:00
New Client Intake Form
Business Name
(Required)
Business Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Main Business Phone
(Required)
Primary Contact
(Required)
Primary Contact Phone
(Required)
Primary Contact Email
(Required)
Company Website URL
(Required)
What services are being purchased?
Review Revolution
GMB setup and optimization
GMB Management
Directory Listing Service
Select All
GMB/Listing Information
Does The Business Have a Google Business Listing Yet?
Yes
No
Unsure
Has The Listing Been Verified/Claimed Yet?
Yes
No
Waiting on Postcard
Do you want customers to see your address on google?
Yes
No
Business Description
What they do and who they serve? Anything else we want the public to know?
Top 10 Business Categories
List any other social URL's
ie: LinkedIn, Twitter, Pinterest, Facebook, Instagram, Tiktok, Youtube
Complete Business Hours and Special Holiday Hours
List service areas in order of importance
Is the business veteran owned?
Yes
No
Is the business women owned?
Yes
No
Is the business wheel chair accessible?
Yes
No
Is/are the bathroom(s) Unisex?
Yes
No
GMB/Listing Special Notes and Questions
Review Collection Information
Where would you like customers to leave reviews?
(Required)
Google
Facebook
Yelp
Other
What other review sites should be included?
List all URL's where reviews will be sent to:
Email address for survey responses
(Required)
Email address if a customer wants to contact management
(Required)
Phone number if a customer wants to reach out to you about their experience
(Required)
Does the client have software with automatic email or text capability?
(Required)
Yes
No
What is the software that will be used?
How will feedback requests be sent?
(Required)
Email
Text
Both Email and Text
Review Revolution Special Notes
Client's Logo
Drop files here or
Select files
Accepted file types: png, pdf, ai, jpg, eps, Max. file size: 2 MB, Max. files: 6.
Landing Page
Only fill out fields that require changes. Leave a field blank if no changes are required.
Tell it to us straight!
How likely are you to recommend (company name) to friends and family?
Low Funnel (0-5 rating)
Only fill out fields that require changes. Leave a field blank if no changes are required.
We are sorry that your experience did not go well. Which area(s) need improvement?
(Quality of work) (Customer Service) (Timeliness) (Other)
What could have been done differently to improve your experience?
We would like the opportunity to try and make things right. Please enter your contact information below so we can reach out to you.
Low Funnel Special Notes
Mid Funnel (6-8 Rating)
Only fill out fields that require changes.
What could we have done differently to make your experience a 10?
Would you like us to reach out to you?
(Yes) (No)
Mid Funnel Special Notes
Survey Confirmation
This is what the customer sees after they click submit on a 0-8 rating.
Thank you for taking the time to help us learn to serve you better. Let us know if there is anything else we can help you with. (Business Phone)(Management Email)
High Funnel (9-10 Rating)
Only fill out fields that require changes.
We are glad that you were pleased with your experience. Are you able to help us out by leaving a google review? Pretty Please...
(Sure!) (No, thanks.)
Thank you very much for supporting us! Click on the link and it will take you there directly.
High Funnel Special Notes
Page load link
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