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Business Name
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Project Start Date
Which services are you interested in?
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(Select from the list below)
HighLevel Automation Setup
Funnel or Website Design
A2P Phone Number Registration
Real Estate VA
Medical VA
Executive VA
Social Media Management (SMM)
LinkedIn Lead Generation & Appointment Setting
Others
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Budget Range
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<$1,000
$1,000–$5,000
$5,000+
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What is your preferred payment structure?
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Fixed monthly package
Hourly rate
Not sure, please advise
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How did you hear about me?
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LinkedIn
Instagram
Facebook
Tiktok
Google search
Referral from a friend
Freelance platform (e.g., Upwork, OLJ)
Others (Please specify at the end part of this form)
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Do you need help building a landing page or website for your business?
Yes
No
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Do you already have a design or branding guide to follow?
ie. logo, colors, fonts
Yes
No
I need help with that
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What type of page are you looking for?
Starter Funnel (1–2 pages)
Growth Funnel (up to 4 pages with booking calendar)
Business Website Funnel (up to 5 pages)
Not sure / Need advice
Do you already have a HighLevel account setup?
Yes
No
Not yet, but planning to
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Are you looking to automate tasks like follow-ups, lead responses, or internal workflows?
Yes
No
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Which automation setup package would you like?
(Choose one)
Basic Setup – 1 simple automation
Standard Setup – Up to 3 automation flows
Premium Setup – Full account + custom automations
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Do you need help setting up a calendar or booking system in GoHighLevel?
Yes
No
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What kind of calendar do you need?
1-on-1 Booking
Team Calendar
Class Booking/Event
Others
Do you want it connected to automated confirmations and reminders?
Yes
No
Not Sure
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Do you need help calling leads and setting appointments for your business?
Yes
No
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What’s your target market or industry?
Do you already have a script and list of leads?
Yes
No
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Which package best fits your needs?
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Starter Package
Growth Package
Pro Package
Not sure yet, I need help deciding
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Do you need help with day-to-day administrative tasks?
Yes
No
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What tasks do you want support with?
Email & calendar management
File organization
Document creation
Others
What kind of help do you need most?
Are you open to training someone on your current workflow?
Yes
No
I’d prefer someone with medical VA experience only
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What is your preferred hourly rate range for this role?
(This helps us match you with the right support for your budget.)
<$7/hour
$8–$10
$10+/hour
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What system or platform are you currently using for appointments and patient records?
What industry or niche is your business in?
Do you already have social media pages set up? If yes, please list the platforms.
Do you already have a logo, branding kit, or visual identity we should follow?
Yes, I have a full brand guide
I have a logo but no full branding
No, I need help with branding
Other (please specify)
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Which SMM package are you interested in?
Starter Package
Growth Package
Pro Package
Custom package (let's discuss)
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What is your business or service about?
Who is your ideal target audience on LinkedIn?
Do you already have a lead list (CSV or spreadsheet) of people you’d like to reach out to?
Yes, I’ll upload it
No, I need help building one
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What’s your expected hourly budget for LinkedIn outreach support?
*
<$7/hour
$8-$10/hour
$10+/hour
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What is your business name (legal entity)?
What is your industry?
How do you primarily communicate with your leads or clients?
Text messaging (SMS/MMS)
Calling (manual or auto-dialer)
Both texting and calling
Other: (Please specify)
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What type of service or assistance do you need? If it doesn’t fit any of our options, please elaborate.
Is there anything else you'd like help with or want to share about your needs?
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