New Client Intake Form

Contact Information

First name
Bilbo
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Last name
Baggins
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Phone number
123-123-1234
Please enter a valid 10 digit phone number. E.g. 123-123-1234
Email address
Please enter a valid email address. E.g. [email protected]
Billing address
1234 Main St, Seattle, WA 98116
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Login Information

Which services are we providing you?
We need certain logins for each service. It wont hurt to check them all if you're unsure.
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Please share access to your Google Analytics with [email protected]
For a video tutorial CLICK HERE
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Please share access to your Google Webmaster Tools account with [email protected]
For a video tutorial CLICK HERE
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Do you have access to your website hosting dashboard? (cPanel)
For a video tutorial CLICK HERE
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Hosting or cPanel login URL
This is the page you access to login to your hosting dashboard.
http://
Please enter a valid URL. E.g. http://example.com
Username
cpaneluser
Field is required!
Password
password123
Field is required!
Please explain why you can't access your hosting dashboard.
I don't have the password or I don't know what a hosting dashboard is...
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Do you have access to your website admin panel?
For a video tutorial CLICK HERE
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Website admin panel login page URL
For WordPress it's typically http://example.com/wp-admin
http://
Please enter a valid URL. E.g. http://example.com
Username
adminuser
Field is required!
Password
password123
Field is required!
Please explain why you can't access you website admin panel.
I don't have the password or I don't know what an admin panel is...
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