A beginner-friendly guide to the words, decisions, and warning signs that matter before you spend real money on branding, creative, ads, or a full-service marketing partner.
If answers get vague on claims review or tracking, keep looking.
Then use the readiness worksheet on this site if you want a structured self-check before a sales call.
A single monthly number is hard to judge until you know what is inside it. Separate provider fees (what you pay the agency or consultant) from ad spend (what you pay Meta, Google, Bing, or other platforms). Ad spend is not agency revenue.
Use this worksheet for each written proposal. Fill only the lines that apply. Zero only a line that is already included in another fee. Claims-review inclusion inside leadership does not mean all creative production is included. Do not zero creative merely because claims review is included. If a provider itemizes a bundled fee for comparison, do not add those breakout lines again on top of the bundled total. If a line is unknown, leave it blank; do not silently estimate or include it.
| Line | What it is | Proposal A | Proposal B | Ask / notes |
|---|---|---|---|---|
| Leadership / strategy fee | Owns growth decisions, priorities, measurement rules | $____ / mo | $____ / mo | What decisions does this buy? What stays on my team? |
| Paid media management (optional) | Running ads day to day: provider fee, not ad spend | $____ / mo | $____ / mo | Which channels? Who owns ad accounts? Enter 0 if not purchased |
| Creative / production (monthly) | Ongoing ads, pages, content production: provider fee | $____ / mo | $____ / mo | Zero only if this production fee is actually inside another fee line |
| Provider fee subtotal (monthly) | Leadership + media management + creative monthly | $____ | $____ | Fees paid to the provider. Do not put ad spend here |
| Ad spend (monthly) | Money paid to Meta, Google, Bing, etc. | $____ / mo | $____ / mo | Not a provider fee; not agency revenue |
| Combined monthly budget | Provider fee subtotal + ad spend | $____ | $____ | Total cash out the door each month |
| One-time setup | Launch, tracking setup, migrations, builds | $____ once | $____ once | Provider fee unless stated otherwise |
| First-three-month combined budget | One-time setup + (3 × combined monthly budget) | $____ | $____ | See formula assumptions below |
Formulas (same for every provider):
Assumptions: The 3× shortcut assumes recurring monthly amounts stay constant and listed one-time fees occur once. If month-to-month amounts vary, add actual month 1 + month 2 + month 3 (plus one-time fees) instead of using 3×.
These are buyer questions. Fill from each provider's written terms. Do not assume Off-Label contract language from this page.
| Term | Proposal A | Proposal B | Ask |
|---|---|---|---|
| Minimum term | ________ | ________ | How long are you locked in before month-to-month or exit? |
| Cancellation notice | ________ | ________ | How many days' written notice to end? |
| Setup-fee refundability | ________ | ________ | Is any setup fee refundable, partially refundable, or non-refundable? |
| Scope-change rates / approval | ________ | ________ | How are extra scope items priced, and who must approve before work starts? |
Off-Label's base offer for new clients is fractional CMO leadership work. Optional paid media management can be added when you choose it. For what that leadership fee includes, see fractional CMO for telehealth.
Also useful when you compare ownership and build-vs-buy: who owns your ad accounts and should we hire a healthcare growth agency or build in-house.
Hypothetical only. Not Off-Label prices and not market benchmarks. Teaching arithmetic for the worksheet.
Suppose Proposal A quotes:
Provider fee subtotal = 4,000 + 2,500 + 0 = $6,500 / month
Ad spend = $8,000 / month (not a provider fee)
Combined monthly budget = 6,500 + 8,000 = $14,500
First-three-month combined budget = 3,000 + (3 × 14,500) = 3,000 + 43,500 = $46,500
If creative were not bundled and quoted at $1,500 / month instead:
Provider fee subtotal = 4,000 + 2,500 + 1,500 = $8,000 / month
Ad spend = $8,000 / month
Combined monthly budget = 8,000 + 8,000 = $16,000
First-three-month combined budget = 3,000 + (3 × 16,000) = $51,000
You do not need to become a marketer before hiring marketing help. But you should know enough plain English to tell whether someone is explaining clearly or hiding behind jargon.
These are the starter set. The full vocabulary, every term with what operators get wrong about it, is the telehealth marketing glossary.
Money your business brings in before expenses.
Money left after you pay the costs of running the business.
Getting the right people to know you exist, understand why you matter, and take the next step.
Turning interested people into paying patients, customers, partners, or clients.
What people think and feel when they hear your name.
The visible and verbal pieces that shape your brand: name, logo, colors, voice, design, website, photos, and messaging.
The answer to: why should someone choose you instead of another option?
What you are asking someone to buy, book, join, download, or try.
Someone who has shown interest, usually by filling out a form, booking, calling, replying, or downloading something.
When someone takes the action you wanted them to take.
Customer acquisition cost. How much it costs to get one new paying customer or patient.
Lifetime value. How much money one customer or patient may be worth over time.
The path from first hearing about you to booking, buying, subscribing, or becoming a patient.
The actual stuff people see: ads, videos, images, landing pages, emails, copy, posts, and design.
Return on investment. Whether the money you spent created enough value to be worth it.
Return on ad spend. Revenue attributed to ads divided by what you spent on those ads.
Media efficiency ratio. Total revenue divided by total media spend. Useful when attribution is messy.
New customer acquisition cost. What it costs to acquire a first-time customer or patient.
New customer media efficiency. Revenue from new customers divided by media spend.
Cost per acquisition, or cost per new acquisition. Always define the action: lead, booking, intake, paid order, or approved patient.
Cost per click. Useful for reading media pressure, but not business health by itself.
Average order value, sometimes separated for new customers. Important when first purchases and repeat purchases behave differently.
The percentage of revenue left after direct costs. This helps show how much acquisition cost the business can absorb.
How long it takes gross profit to recover acquisition cost. This matters when runway is limited.
New website visits versus returning website visits. Helps separate new demand from people coming back to decide.
Effective cost per new visit. Useful when a campaign is meant to create new demand.
A strong brand helps people recognize you, trust you, and remember you. That matters. But early on, branding usually pays off over time. If you need near-term revenue, you need to test the things closest to action: the offer, the message, the landing page, the follow-up, and the path to booking.
The first question is not always, "Do we look polished enough?" Sometimes it is, "Can the right person understand what we do, believe it is for them, and take the next step without getting confused?"
A fractional paid-media operator recently audited six DTC ad accounts after each client asked for "more creative" to fix a rising cost-per-acquisition. In five of the six, the real leak was a stale offer and a checkout that hadn't been touched in a year, not tired ads. Fixing the offer and the mobile checkout on two of those accounts moved CPA faster than six months of creative testing had. Read that as one operator's account, not a controlled study — but it is the same pattern we see across telehealth intake flows: the "landing page" is a multi-step medical intake form, and it is usually the actual bottleneck, not the ad.
Weighing paid media specifically? See Before You Run Paid Ads before you brief anyone on creative.
This is the simplest way to avoid buying a beautiful system before you know what the market responds to.
What are you selling, who is it for, what problem does it solve, and why should someone act now?
Can someone easily book, buy, inquire, subscribe, or take the next step without friction?
Which words, angles, objections, and patient anxieties actually move people?
Which ads, videos, pages, emails, or posts create response from the right audience?
Once you have signal, make the look, voice, and experience more consistent and memorable.
CAC measures the cost to acquire a paying patient. CPL measures the cost to acquire a lead. Lead numbers alone do not show paying-patient CAC. Before you draw CAC conclusions, compare matching cost scope, time period, and attribution, and look at lead-to-patient conversion. Offer clarity and the conversion path can be useful diagnostic questions, not asserted causes. If you compare "fully loaded" costs, state which costs are included before comparing.
Good agencies make the work clearer. Weak agencies make the process feel fancy while the business question stays blurry.
Physicians and telehealth operators are often buying work they cannot easily judge: strategy, positioning, funnels, ads, creative, content, and brand systems. An advocate helps define what should be bought, what can wait, what success means, and whether the work is actually moving the business forward.
Fill this out before you hire, brief, or evaluate an agency. If you cannot answer a section yet, that may be the real project.
What needs to improve?
How will we know the work succeeded?
Who are we trying to reach?
What do they already believe or worry about?
What do we want them to buy, book, join, or try?
Why should they act now?
What happens after someone clicks?
Where are people dropping off?
What claims, words, or promises should we avoid?
Who needs to approve the work?
What are we buying now, and what can wait?
What would make this spend feel worth it?
Bring the proposal, brief, deck, or agency pitch. We will look for the gaps between what you are buying and what your business actually needs next.
Review the telehealth advertising compliance guide for the claims and creative patterns to discuss with an agency.
Before you sign, settle who owns your ad accounts, website, and data if you part ways.