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PPC Questionnaire

Launch Ads Pay-Per-Click Questionnaire

Initial Questionnaire for Google Ads Campaigns

Client Name*
Primary Contact(s)*
Please include First and Last Name
Website*

Must include full domain - i.e. http://www.domain.com
Contact Phone Number*
Contact Email*
What Practice Management Software do you currently use?
What Would You Like To Advertise?
We recommend focusing the campaign on a specific Procedure or Offering, such as "Dental Implants", "New Patient Special", "Wisdom Teeth Removal"
How Much Would You Like Your Click-Budget to Be?

PBHS will review your questionnaire and recommend a click budget during your consultation, based on your goals. However, if you already have a budget in mind, please let us know.
Do You Have a Special Offer or “Call to Action” You Would Like to Highlight in Your Campaign?
Offering clients an incentive to call or email will almost always increase CTR & ROI. If you would like recommendations during your consultation, let us know.
Is There Anything About Your Practice That You Would Like to Emphasize in the Advertisements?
Years of Experience, Certifications, Affiliations, etc
Who Do You Consider to Be Your Top 3 Competitors
How Do You Currently Acquire Most New Patients?
Do You Accept Medicaid?
- Yes
- Yes, But I Don't Want to Advertise For It
- No
If you do not accept Medicaid, we will want to add it as a negative keyword.
What Geographic Area Would You Like to Target?
We generally recommend starting with a 20-mile radius around your office. However, if you have specific areas you would like us to target, or exclude, let us know here.
During What Hours Would You Like Us To Run Your Ads?
We generally recommend running ads during your office hours when someone is available to answer calls. However, if you have someone available to answer calls after hours or when you are closed, let us know.
Where Would You Like Email Leads to Be Sent?

This is the email address that will receive contact form submissions from the campaign. It will not be visible from the site.
What Phone Number Would You Like to Receive Tracked Phone Calls

As part of your campaign, we will be tracking phone leads using a tracked phone number. Where would you like those calls routed?
Would You Like Your Phone Calls Recorded?
- Yes
- No
Call Recording is Included in the campaign, but some clients prefer not to use that function. If you would not like call recording enabled, we can still track the calls that are received, but you will not be able to listen to the calls.
What credit card would you like to use with Google?
- I would like to use the same card I entered on my order with PBHS
- I would like to use a different card
You may opt to use a different card then the one we have on file. The billing will come directly from Google, Inc
Please have the Credit Card you would like to use available during your consultation.
Address
This field is for validation purposes and should be left unchanged.