Practice Name Primary Contact Name First Last Primary Contact Email(Required) Do you have a website with Gargle(Required) No Yes Yes, we are having a new site built by Gargle Other Please confirm the phone number that your ads should be directed to?(Required)Please confirm the email address that your ad submissions should be sent to.(Required) How many patients do you wish to aquire each month through our PPC / Google Ad efforts??What is the average first year value of a new patient in your practice (in dollars)?(Required)How much is your past, current or expected CPA (cost per aquisition) using PPC for a new patient?(Required)Have you run Google ads before coming to Gargle?(Required) No Yes Im not sure Other If you have run ads before, do you have access to an exisiting Google Ads account?(Required) No Yes Maybe - I will have to find out. If you have access, please provide you Googel Ad Account ID here: If you have run Google Ads before, what types of ads did you promote?Gargle usually sets up your ad radius to run for users within 10 miles of your office location. Do you have other areas you wish us to research or run ads for that are different than that? No Yes Other If so, what areas?Do you have any specific ad campaign ideas you would like us to research?(Required) Dentist Near Me Emergency Dentist Cosmetic Dentist Pediatric Dentist Orthodintics Sedation Dentistry Dental Crowns Dental Implants Invisalign / Clear Aligners Sleep Apnea Wisdome Teeth Extractions Select AllPlease describe any specials or offers you wish to promote with you ad campaings.What is your desired monthly budget per month?(Required) $250 (Gargle minimum per campaign) $500 $750 $1000 >$1000 - $1500 >$1500 Other Please tell us anything else you think would be valuable for us to know when researching and planning your Google Ads?
