Fractional CMO Client Intake Form

This field is for validation purposes and should be left unchanged.

Contact person completing this form*

(Name – Required)

Best email for follow-ups*

(Email – Required)

Best phone/text*

(Phone – Required)

Estimate 15–25 minutes. You can Save & Continue anytime.

Legal business name*

Doing Business As (DBA) / Fictitious Name If Any*

Primary location address*

Website URL*

Main practice phone*

General Business Email*

(Email - Required)

Number of Employees

Years in business

Office hours

Day

Open

Notes

Owner/Manager Name*

Owner/Manager Email*

Owner/Manager Phone (Mobile Preferred)*

Marketing/Office Contact Name*

Marketing/Office Contact Email*

Marketing/Office Contact Phone*

Technical/IT Contact Name

Technical/IT Contact Email

Who Approves Content/Ads?

Owner

Office Manager

Marketing Lead

Other

Do you have additional locations?

Yes

Add locations*

Name

Address

Phone

Booking link

Top 3 priority services to grow

Service 1

Service 2

Service 3

Languages spoken

List Any Ongoing Offers/Special(s)

E.g. Discounted pricing/offers with any exclusions, limits, or expirations.

One-sentence value proposition for your business*

Why choose you?

Brand tone

Warm

Clinical

Family-friendly

Luxury

Minimally invasive

Tech-forward

Faith-friendly

Other

Your Top 3 Competitive Differentiators

Differentiators 1

Differentiators 2

Differentiators 3

Logo upload

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, svg, Max. file size: 128 MB.

Brand colors / fonts (include hex# color codes if known)

Your brand color palette (your graphics designer will have this)

Google Business Profile URL

GBP primary categories

Google Business Profile Account Owner Email(s)

Which Google account(s) currently own your business listing?

Invite our agency emails to co-own GBP (sean@leadeagle.io + integrations@leadeagle.io)

Yes, invitation sent

Please invite both the above emails as account owners from the primary owner account.

Bing Places (URL)

Yelp (URL)

Facebook Page (URL)

Instagram (URL)