New Web Site Design Assessment

Please, enter the URL of a web site, which you would like to immitate in look and feel. Why do you like this site?
Please, enter another URL of a web site, which you would like to immitate in look and feel. Why do you like this site?
Please, enter one more URL of a web site, which you would like to immitate in look and feel. Why do you like this site?
Do you have any photos or images you would like me to use on your web site? (Send them to me as an e-mail attachment)
Yes  No  
Do you have an account with Practice Pay Solutions, 1Shoppingcart.com, or any other e-commerce system?
Yes  No  
If yes, enter your provider's URL, user name and password, where I can access your account
If you have any color preferences, list them here:
Your web site copy is written and ready to go on your web site:
Less True - 1 2   3   4   5   - More True
What computer programs are you proficient in?
Your Internet skills (e-mail, browsing, saving, etc.) is excellent:
Less True - 1 2   3   4   5   - More True
Any other comments you'd like to share with me, before I start designing your web site?
Your Name:  

Your Email:  

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