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About
Services
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Contact
let,s talk
Website Questionnaire for
Nephrologists
SECTION 1 — Contact Information
Doctor's Full Name
Email Address
Clinic / Practice Name
Phone Number
Preferred Contact Method
Email
Viber
Phone
Best Time to Reach You
Morning (8AM - 12PM)
Afternoon (12PM - 5PM)
Evening (5PM - 8PM)
SECTION 2 — Practice Details
Type of Practice
Solo Practice
Group Practice
Hospital-Based
Telehealth Only
Number of Doctors in Practice
Clinic Address / Primary Location
Do you have multiple clinic locations?
Yes
No
Please list your additional clinic locations
Years in Practice
Less than 1 year
1 - 5 years
5 - 10 years
10+ years
Services Offered at Your Practice
Chronic Kidney Disease (CKD) Management
Dialysis (Hemodialysis / Peritoneal)
Hypertension & Blood Pressure Management
Kidney Transplant Care
Pediatric Nephrology
Electrolyte Disorders
Glomerular Diseases
Telehealth Consultations
Other
Please specify other services
SECTION 3 — Online Presence & Hosting
Do you currently have a website?
Yes, I have a website
No, I do not have a website
Current Website URL
Are you happy with your current hosting provider?
Yes, I am happy with my hosting
No, I want to change hosting
What do you dislike about your current website?
Do you need us to arrange hosting and domain registration?
Yes, please arrange hosting and domain for me
No, I will arrange it myself
Preferred Domain Name (if no domain yet)
Do you have existing branding (logo, colors, fonts)?
Yes, I have a logo and branding materials
No, I need branding created
SECTION 4 — Website Goals & Requirements
What service do you require?
Building a brand new website
Redesigning my existing website
What is the primary goal of your website?
Attract new patients
Educate existing patients about kidney health
Online appointment booking
Showcase credentials and specializations
Telehealth integration
Build trust and professional image
Other
Please specify your other goals
Describe your ideal website in 3 words
Which websites do you admire and why?
Do you need an online appointment booking system?
Yes
No
Maybe later
Do you need patient forms or downloadable resources?
Yes
No
Do you need a health blog or patient education articles section?
Yes
No
Do you need multilingual support?
Yes
No
Maybe
SECTION 5 — Content & Media
Do you have professional photos of yourself or your clinic?
Yes, I have professional photos
No, I need a photographer referral
I will use stock photos for now
Do you have written content ready (About, Services, etc.)?
Yes, content is ready
No, I need copywriting help
I have partial content
Will you manage the website yourself after launch?
Yes, I will manage it myself
No, I need someone to manage it
I need training to manage it
Do you need ongoing website maintenance after launch?
Yes, monthly maintenance
Yes, as-needed only
No, not at this time
SECTION 6 — Budget & Timeline
Estimated Budget Range
Below $500
$500 - $1,000
$1,000 - $2,500
$2,500 - $5,000
$5,000+
Let's Discuss
How urgent is this project?
ASAP — I need it urgently
Within 1 month
Within 3 months
No rush, take your time
SECTION 7 — Final Notes & Agreement
Any specific concerns, questions, or additional information you'd like to share?
Submit Questionnaire