Use This Form to Request a No-Obligation Quote for Your Project Today!

DISCOVERY QUESTIONNAIRE(Type directly on this document or you can print it out.)

1. Your name: 2. Your title: 3. Your company:4. Address: 5. City:6. State/Province: 7. Zip/PC:8. Phone number:9. Email address:10. Website: 11. The name of your product or service:12. Market for your product or service (Who are you selling to?)

a. Demographics :Gender: (Please mark with an “X”.) Male [ ] Female [ ] Both [ ]Age group: Health status or issues:Marital status:Children:Socio-economic background:Geographic location:Hobbies:Any other information you deem important:

b. Psychographics :Any significant psychological, emotional, and/or mental challenges that they wrestle with:

Any significant physical, physiological, and/or metabolic challenges that they wrestle with:

Any other information you deem important:

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13. The kind of copy you need: (Please mark with an “X” to all that apply.)[ ] Landing Page [ ] Email [ ] Direct Mail[ ] Website [ ] Web Page [ ] E-Newsletter[ ] Sales Letter [ ] Lead Generation [ ] Search Engine Optimization[ ] Video Script [ ] Banner Ads [ ] Taglines[ ] Funnel Campaigns [ ] Case Study [ ] Other: (Write here)

14. The desired length of the copy: (How many pages, words, minutes?)15. The purpose of the copy: (Please mark with an “X” to all that apply.):

[ ] Generate inquiries [ ] Answer inquiries[ ] Generate sales [ ] Build awareness[ ] Transmit information [ ] Build company image[ ] Announce new products [ ] Other: (Write here.)

16. Please enclose any literature that will provide me with the information I need to write your copy. This can include previous promotions and controls, direct mail, sales letters, emails, videos (including scripts), ads, brochures, mailings, article reprints, press releases, internal memos, proposals, technical papers – send whatever you feel appropriate. Don’t worry about organizing the material. I’ll do that. If these materials are not available in electronic format you can fax them to me or please contact me and I will provide you with a physical address. (Please note: These items will NOT be returned to you.)

17. What are the key selling points about this product or service? (Please elaborate.)

18. What is your deadline date (the date you need to receive the finished copy)?

19. Please add any additional comments (Attach any additional pages needed.):

You can reach me between the hours of 8:30am and 5:30pm EST Monday to Fridays. If you wish to fax me documents, please call me at 647-631-6609 or email me at Ellery@RemedyCopywriting.com and I will provide you with a fax number.

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