Practitioner Technical Intake

Complete this multi-step intake questionnaire to provide your clinical practice specifications, brand assets, treatment philosophy, and service programs. Your progress is saved at each step, and you can log in to resume at any time.

Step 1 of 6 // Account Initialization Progress Auto-Saved
01 Contact Contact & Setup
02 Logistics Domain & Tech
03 Branding Visual Assets
04 Audience Positioning
05 Content Copy & Offer
06 Review Programs & Submit

01 // Contact & Account Initialization

Your primary contact first name.
Your primary contact last name.
The legal or brand name of your practice, clinic, or consulting firm.
Direct contact number for onboarding support.
The email address used for portal authentication and project updates.
Toggle whether your practice is 100% virtual/telehealth or has a physical clinic address.
Link to your practice Facebook page.
Link to your practice Instagram profile.
Link to your professional LinkedIn profile.
Link to your clinical YouTube channel.

02 // Domain & Tech Logistics

Toggle whether you have registered a custom website domain.
Your domain address (e.g. myclinic.com).
Where your domain is registered (or where you plan to register). Passwords are never collected.
Your clinical booking platform (Calendly, Acuity, SimplePractice, Jane App, Kareo).
How you accept client payments (Stripe, Square, QuickBooks, Authorize.net).

03 // Branding & Visual Assets

High-resolution PNG with transparent background preferred, SVG, PDF, AI, or PSD (Max size: 20MB).
Hex codes (#0A2540), Pantone numbers, or general color description (Primary, Accent, Background).
Describe your clinical aesthetic: Holistic & Grounded, Scientific & Medical, High-End Wellness, Warm & Calming?
Toggle whether you would like our design team to curate matching modern typography or if you have custom fonts.
Upload clinical headshots, treatment rooms, consultation spaces, or workspace photos (Max 20MB per file).

04 // Target Audience & Positioning

Who is your core target audience? (e.g. Individuals suffering from chronic fatigue, high-performance athletes, post-surgical recovery, holistic health seekers).
Your clinical focus (e.g. Functional Medicine, Acupuncture, Integrative Physical Therapy, Naturopathic Oncology).
What sets your practice apart from conventional or competing practitioners?
A memorable phrase capturing your clinical mission.

05 // Website Copy & Content

Your professional background, credentials, degrees, board certifications, and clinical journey.
What inspired you to enter this field and practice?
Provide 2-3 patient testimonials or reviews, including first names.
Title of your free PDF guide, self-assessment checklist, meal plan, or consultation voucher. Upload a PDF guide or resource file for your lead magnet.

06 // Clinical Offerings, Packages & Final Review

Define your primary care packages, consultation options, and disclaimers. Complete final review and submit your profile.

Program 01
Program 02
Program 03
List optional add-on modalities, extra lab interpretations, genetic counseling, or acute consultations.
Toggle whether you would like standard clinical/educational disclaimers added or if you provide custom legal language.
Toggle whether you need generic legal footer templates added or have custom legal links.