free online business evaluation

Thank you for deciding to take the next step with NetSmart Media. We have prepared a short form for you to fill out below. Please answer all the questions in detail. After you submit the form you will be contacted by one of our representatives to discuss your goals.

IMPORTANT: Please make sure to read the Services & Pricing page before submitting your evaluation. That page discusses the pricing of our services and exactly what you can expect and the pricing our service. Please make sure you have the budget available before submitting this form.

IMPORTANT: At NetSmart Media our goal is get your trafic. We are NOT responsible for client sales, conversion, sales copy or sales funnels. These areas are solely the responsibility of the client and NetSmart Media will not work on these areas for you.

*First Name

*Last Name

*Address

*City

State

*Zip/Postal Code

*Country

*Phone Number

*Email Address

How did you hear about us?

*Do you have a website?

Yes No

What is your domain name?
How long has your site been online?
Less than 1 year 1-3 years 3-5 years More than 5 years
What purpose does your website serve?
To generate leads for your business To sell products online To build company image Other, please explain..
How are you currently generating traffic to your site?

Do you use paid online advertising?	Yes No
If you are using paid online advertising, what is your monthly budget?
$1000 or less $1001 - $5000 $5001 - $10000 Over $10000
Please explain your experience working with other companies when it comes to your website and/or web presence...

What is your reason for starting a website now?

What do you want your website to accomplish?
To generate leads for your business To sell products online To build company image Other, please explain..
Do you plan on using paid online advertising?	Yes No
If you plan on using paid online advertising, what is your monthly budget?
$1000 or less $1001 - $5000 $5001 - $10000 Over $10000
Please explain your experience working with other companies (if any) when it comes to your website and/or web presence...