Practitioner Intake Form This form helps us understand your practice, goals, and current marketing situation to make your free consultation valuable. Takes about 3–4 minutes. All answers are confidential. "*" indicates required fields CommentsThis field is for validation purposes and should be left unchanged.1. Your Contact Information | Full Name* First Last Email* Phone Number*Website or Primary Online Presence URL (e.g., Instagram, LinkedIn) 2. Your Practice & Niche | What type of wellness practitioner are you?How long have you been operating your practice? Less than 1 year (just starting out) 1-2 years 3 - 5 years 6-10 years 10+ years 3. Your Current Marketing Activity | Which marketing activities are you currently focusing on? (Select all that apply) Social Media (Organic Posts) Paid Ads (Facebook, Instagram, Google, etc.) Email Marketing / Newsletters Blogging / SEO (Search Engine Optimization) Referrals / Word-of-Mouth Networking / Local Events I'm not doing any intentional marketing yet How would you describe your overall confidence in your current digital marketing strategy? 1 Not confident at all 2 3 4 5 6 7 Highly confident 4. Your Goals & Expectations | How many new clients/customers would you ideally like to attract per month? 1–2 new clients/month 3–5 new clients/month 6–10 new clients/month 10+ new clients/month I offer group programs / courses, not 1-on-1 What is the urgency level for achieving your growth goals? 1 Not urgent 2 3 4 5 Extremely urgent What is your estimated monthly budget for new marketing campaigns (ad spend + services)?$0 - I need to start with free/organic only$100–$300/month$300–$700/month$700–$1,500/month$1,500+/monthFlexible - depends on ROI5. Anything Else We Should Know? (Optional)Consultation Confirmation: By submitting this form, you confirm that you're interested in a free 15-minute consultation with the We Move to Heal team.* Yes, I confirm my interest in the free consultation.
