SEO Intake Form

Help us understand your market, goals, and target areas.

Search engine optimization (SEO) isn’t one-size-fits-all—and that’s especially true for independent medical, dental, and orthodontic practices.

At Virginia Creative Group, we build SEO strategies around your practice: your patients, your services, your neighborhoods. This intake form helps us understand where you want to grow, what search terms matter most to you, and how your community finds care online.

Whether we’re working on your website content, Google Business Profile, Google Ads, or blog strategy, this form ensures we’re making smart, localized decisions that drive real results.

📍 Have more than one location?

Please complete this form separately for each location. Local SEO is most effective when we can tailor it to each office’s community, search habits, and service area.

📝 What we’ll ask about:

ZIP codes and neighborhoods you want to rank in
Search terms you wish you ranked for
Services you want to grow
How patients search for care in your area
Your competitors, your differentiators, and your ideal audience

Filling this out gives us the roadmap to make your digital presence not just stronger—but smarter.

SEO & Local Targeting Intake Form

Help us optimize your digital presence. To build a strategy that helps you stand out in local search results, we need your input. This form gathers key details about your target service areas, keywords, ideal patients, and more. Your responses will directly shape how we optimize your website, Google Business Profile, paid ads, and content strategy. Please complete this form as thoroughly as possible. The more detail you provide, the more precise and effective your SEO results will be.

"*" indicates required fields

Name*

First Last

Practice Name:*

Email*

Website URL:*

Office Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Hours:*

What ZIP Codes are most important to this location*

(List in order of priority if possible)

Are there local city or neighborhood names you want to rank for that patients use commonly?*

(Ex: “Cherry Creek,” “Uptown,” “Downtown Raleigh,” etc.)

How far do MOST of your patents drive to see you?

Are there nearby towns/regions where you want to attract new patients?*

(Even if your office isn’t located there)

What services do you want to be known for?*

(List specialties, treatments, or procedures – ex: clear aligners, pediatric dental exams, Mohs surgery)

What search terms do you want to show up for on Google?*

(Ex: “pediatric dentist near me,” “TMJ specialist,” “braces in Denver”)

Are there services you don’t want to promote heavily or rank for?*

(This helps us avoid mis-targeting)

Who are your top 2–3 local competitors?*

(Include websites if possible)

What year did you start your practice?*

What’s your ideal patient demographic?*

(Examples: age range, insurance preferences, family vs. individual, medical concerns)

Are there specific employer groups, neighborhoods, or schools you want to reach?*

Please list questions and answers you often get asked in your office. Think about the questions you hear every day—from both current patients and prospective ones.*

These could be about: • Treatment options or procedures • Insurance or pricing • What to expect at the first visit • Concerns about pain, safety, or timing • Questions specific to your niche or specialty Knowing what your patients are asking helps us create website content, blogs, and Google Ads that speak directly to their needs—and boost your visibility in search.Don’t overthink this—whatever comes to mind is helpful!