Questions to ask an SEO or marketing agency, for practice owners

Nine questions to ask any agency before you sign.

Ask any SEO agency nine questions before you sign: who owns the accounts, what the contract term is, which searches and competitors they'll report on, what changes at 90 days, what gets delivered each month, whether you keep Search Console, what they'd tell you not to buy, and whether you can see a real report. Bad answers cost nothing.

Local search is unusually easy to fake: results differ by who is searching and where they are standing, so almost any screenshot can be made to look like a win. That is not an argument against hiring anyone. It is an argument for questions whose answers can't be dressed up. Each one below ends with our own answer, so you can hold us to it.

Written by Gerad Patton, founder of Ark Visibility · Last reviewed September 23, 2026 · Sources listed at the end

01Ask these in order

The nine questions

Each has a good answer, a bad answer, and a reason it's on the list. The first one alone ends most bad conversations.

1.“Who owns the domain, the website, the Google Business Profile and Search Console at the end?”

Good answer
You do, from day one, on your own accounts. We're a user you can remove.
Bad answer
anything involving "our platform," "we host it for you," or "it transfers when the contract completes."
Why it's here
A website you don't own is a rental you are also paying to improve, and a Google listing an agency owns can leave with its reviews. If the answer is anything other than an immediate "you," stop there.
Our answer
Everything stays in your name. We work as a manager or contributor you can remove at any time.

2.“What's the contract term, and what does it cost to leave?”

Good answer
month to month, no termination fee.
Bad answer
twelve months, with a paragraph about how SEO takes time.
Why it's here
SEO does take time. That is an argument for patience, not a lock-in; a long term mostly protects the seller from a bad third month. Good work is what keeps you paying.
Our answer
No contract, either way. Per-piece work ends when you stop ordering; a monthly plan ends at the close of whichever month you choose, and you keep everything.

3.“Which exact searches will you report on, and will they be the same ones every month?”

Good answer
a written list, fixed, changed only with your agreement and with the old ones still shown.
Bad answer
"we track hundreds of keywords" or "we optimize for topics, not keywords."
Why it's here
A moving keyword set is the oldest trick there is. If the terms can be swapped, a flat quarter looks like a good one by reporting on whichever handful happened to move.
Our answer
The list is written down and approved before month one, and the monthly ranking report shows the searches that did not move beside the ones that did.

4.“Which competitors are you comparing me to, and will they be the same ones every month?”

Good answer
three to five named practices, fixed.
Bad answer
"we benchmark against the industry."
Why it's here
Same searches and same competitors. Both have to be fixed for a before-and-after to mean anything. This rule governs everything else on the list.
Our answer
Named practices, chosen with you from who actually appears for your searches today, and held constant.

5.“What happens at 90 days if the numbers haven't moved?”

Good answer
something specific they'd change: a different set of searches, pages for a different service, a directory record that still hasn't corrected.
Bad answer
a paragraph about how SEO is a long game.
Why it's here
You are testing whether they have a way of diagnosing a problem, or just a content calendar.
Our answer
The audit sets the order of work before anything starts, so at 90 days we can say which step fell short and what we'd change next. We won't say when results will move, because nobody can.

6.“What exactly gets delivered each month? Give me counts.”

Good answer
a table. Two condition pages, four profile posts, review replies drafted for your approval, the technical fixes from the report, one ranking report.
Bad answer
"ongoing optimization," "content strategy," "authority building."
Why it's here
If it can't be counted, it can't be checked, and then you never know whether a slow month was a slow market or a slow month.
Our answer
Every piece is named before the month starts, from a published price list, and billed only after you approve it.

7.“Do I keep Search Console and Analytics on my own login, and what will run on my intake pages?”

Good answer
yes, always, and here's how to read the numbers yourself. And nothing that records or sends what a patient types.
Bad answer
"we handle all the reporting."
Why it's here
Search Console is free, it is Google's own data, and it is the only independent scoreboard in this business. Anyone who prefers you not look at it is telling you something. The second half matters for a practice: Google states that it does not sign Business Associate Agreements for Google Analytics (source: Google); the detail is under the five claims below. We are not lawyers; ask yours.
Our answer
Read-only access to your Search Console, on your login. We recommend keeping ad pixels and session recording off intake, scheduling and portal pages; your compliance adviser decides.

8.“What would you tell me not to buy?”

Good answer
something real. "Don't buy the blog package yet; fix the listing and the booking path first."
Bad answer
everything is recommended.
Why it's here
Nobody needs every service. A seller who won't decline any revenue hasn't looked at your situation.
Our answer
The free audit marks what you can fix yourself in an afternoon. If the honest answer is "fix two pages and claim three listings," the report says that and there is nothing to buy.

9.“Can I see the report I'd actually get, and is it real or a template?”

Good answer
a real monthly report from another client with the name removed, or a complete sample that is labeled as invented on every page and shows the method, not just the layout.
Bad answer
a slide of logos, a template with impressive numbers and no dates, or "confidentiality" with nothing behind it.
Why it's here
Names can be blurred; structure and method can't. A full report shows what they measure and what they admit they couldn't see.
Our answer
Our sample audit is a wholly invented practice and says so on every page, because no client's findings appear on this site without written permission. The one real site we are allowed to show is on the About page, with the relationship disclosed.Related: sample audit.
02Do this before anyone starts work

The one test: search it yourself

Before-and-after screenshots only count if the searches and competitors are identical in both. The free version of that check is you, a friend across town and a staff member all searching the same term on a phone and comparing what you see. Google says distance from the searcher is one of the three things local results are based on (source: Google), so one screenshot from one place is an anecdote by design.

Do it properly; the sloppy version proves nothing either way

01

Use cellular data, not the office Wi-Fi. Your office network tells Google you are standing at your own address.

02

Use a private browsing window , or a phone that isn't signed in to the practice's Google account.

03

Have two other people in different parts of town run the same search. Map results are location-dependent on purpose.

04

Write down what each of you saw, with the date. Repeat in six weeks with the same people and the same search.

Search querydirect primary care [your city]

That is a real measurement, and it costs nothing. A baseline you collected yourself is the only one nobody can adjust later. It is also why we won't show a map grid as proof unless the searches and competitors match across both snapshots.

Each of these is sold to practices today

Five claims that should end the meeting

Any one of them is enough to stop the conversation. Each is impossible, meaningless, or against Google's rules.

“Guaranteed first-page rankings.” Google's own page on hiring an SEO says no one can guarantee a number one ranking and to be wary of anyone who claims to (source: Google). In local results, distance from the searcher is a factor nobody can change.
“We have a special relationship with Google.” There is no such relationship for ordinary search results, and the same Google page lists this claim as a warning sign (source: Google).
“We'll submit you to 500 directories.” A handful of correct listings on the directories patients and AI assistants actually use beats hundreds of auto-generated ones, which at worst scatter wrong addresses you'll pay someone to clean up. Which directories matter for a practice.
“We'll get you reviews.” Google's policy prohibits incentives of any kind, and the FTC's 2024 rule prohibits incentives conditioned on the review being positive (source: Google, source: FTC). Google also prohibits selectively soliciting positive reviews, the FTC rule bans fake reviews, and asking only happy patients is what the FTC calls review gating. The legitimate way is to ask every patient, steadily. How to ask patients for reviews without breaking the rules.
“We'll add your services and city to your business name on Google.” It can work for a while, which is why agencies do it. Google's guidelines say the name must be the real-world name, without extra information, and any competitor can report it (source: Google). Use the name on your door. What we won't do to a listing.

Two more that only a practice hears; the review claim above is the third

“HIPAA-compliant SEO.” Used as a buzzword with nothing behind it. Search work touches public pages and public records, not patient data; the phrase means something only if they can say which tools run on which pages, whether a Business Associate Agreement exists with each vendor that touches patient data, and who at the practice reviews clinical claims. Ask for those three things. If the answer is a logo on a slide, it is a sales word.
Ad pixels or session recording on booking or intake pages. Any proposal that puts an ad pixel, a heat map or a session-recording tool on scheduling, intake or portal pages should stop the meeting. Google states that it does not sign Business Associate Agreements for Google Analytics and that HIPAA-covered entities must not send it protected health information (source: Google). Count clicks, don't record people. We are not lawyers; ask yours.
The reliable good signs

Green flags worth paying more for

The reliable good signs are all forms of turning revenue down.

They ask which visit types and services you most want to grow before quoting anything.
They tell you which of your services not to build a page for yet.
They ask who at the practice will review clinical claims before anything is published under your name. The FTC's guidance says anyone who takes part in marketing a health product or service can be held responsible for its claims, agencies included (source: FTC).
They put the prices on their website. If you had to ask what it costs, ask yourself why.
They'll tell you when paid ads are the better spend this quarter, and mean it.
03In my experience

Why the audit comes first and costs nothing

My family was on the buying side of a bad marketing engagement once: a twelve-month agreement signed before any results existed, monthly reports full of impressions we couldn't spend, and a template with our logo dropped into it. Every rule at Ark Visibility is a reaction to something that went wrong there.

That is why the audit comes first and costs nothing, why every page is shown to you before there is an invoice, why every price is published rather than quoted on a call, and why everything is month to month. I know what the other version feels like from the buying side.

Run these nine questions on us. If any answer disappoints you, that is useful information and you've lost nothing.

How Ark Visibility works, and the eight rules we work byEvery price, published

Asked by practice owners

Common questions about hiring an SEO agency

Ask the nine questions above and listen for specifics: who owns the accounts (you), what the term is (short), which searches and competitors it will report on (fixed), and what it would tell you not to buy. Google's own page on hiring an SEO lists the warning signs in Google's words.

Sources and notes

This guide is general information, not legal or medical advice. We are not lawyers; ask yours about contracts, HIPAA and health claims. We review this page and date each review at the top.

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