Hiring an SEO Agency as a Clinician: What to Ask First

Hire an SEO agency only after it has answered five things in writing: who writes and approves what goes on your site, how it handles reviews and testimonials, what its monthly report shows, who owns the site, profile and content, and how you stop. Price and rankings matter too, but those five answers tell you whether the agency's work will sit comfortably beside your license.

A clinician is in an unusual spot as a buyer. Under APA Ethics Code Standard 5.02, psychologists are responsible for public statements made by people they engage to promote their practice; ACA C.3.c asks counselors to make reasonable efforts to keep what others say about them accurate. Most codes have a version of that idea. Whatever an agency publishes about you, you answer for it.

1. Who writes the pages, and who approves them?

Ask to see the approval step, not just hear about it. A good answer names it: drafts go to you, nothing is published until you say yes, and edits are made before anything goes live. Be wary of "we handle everything so you don't have to think about it". For most businesses that is a selling point. For a licensed clinician it means statements about your training, methods and fees appearing under your name without your review.

Follow up with a practical question: what happens to a page you reject? The answer should be that it is rewritten or dropped, not published anyway because it was "already optimized".

2. What do you do about reviews and testimonials?

This question sorts agencies quickly. Many run review campaigns by default: an email or text to every customer asking for stars. For a practice that is a problem. APA 5.05, ACA C.3.b and NASW 4.07(b) each bar soliciting testimonials from current clients or others vulnerable to undue influence, and a reply that confirms someone was in treatment can be a privacy breach. HHS has settled cases with health practices over exactly that.

The answer you want: the agency never contacts your clients, never writes reviews, and helps you with a general reply policy that doesn't confirm a client relationship. If the agency's local SEO plan depends on a steady flow of new reviews, ask what it does for practices that can't ask for them. Our own view is in can therapists ask clients for Google reviews.

3. What will the monthly report show?

Ask for the outline of a report, row by row. The useful version lists every link placed that month with its live URL, the page on your site it points to and its anchor text; positions for the searches you agreed to target; what changed on your site and Google profile; and what comes next.

Watch for reports built on numbers you can't check: "visibility scores", "domain power", impressions with no connection to inquiries. They can rise while nothing that matters to you changes. A report you can audit line by line is worth more than a polished one you have to take on trust.

4. Where do the links come from?

Links from other websites still count, and they are the part of SEO most likely to go wrong. Ask what kinds of links the agency builds and on what kind of sites. Good answers are specific: guest posts placed through outreach on real websites, pages on established publishing platforms, a minimum quality bar for the sites used. Vague answers ("high-quality backlinks from our network") deserve a follow-up question about who owns that network.

Then ask whether every link will appear in your report. If the answer is no, you have no way to check what is pointing at your site.

5. Who owns what if we part ways?

Your domain should be registered in your name. Your Google Business Profile should belong to your Google account, with the agency added as a manager it can be removed from. The pages written for you should stay yours when you leave. Some agencies register domains in their own name or keep the profile, which turns cancelling into a negotiation.

6. How do I stop, and what happens when I do?

Month-to-month terms let you judge the work without being locked in. Ask how notice is given, whether the current month is billed, and what happens to links already placed. Long minimum terms are not always a red flag on their own, but they shift the risk onto you, and SEO results take months to judge.

7. What do you promise, and what don't you?

No one can guarantee a position on Google, so an agency that does is either guessing or redefining "page one" to mean a search nobody makes. The honest promise is about the work: what will be researched, built and reported each month, and how quickly someone answers your email.

Ask also what the agency won't do. For a practice, the list should include outcome claims about therapy, client stories of any kind (real or composite), tracking pixels that send visitor data to ad platforms, and anything that needs access to client records.

8. Do you work with other practices near me?

Most agencies do, and that is normal. What matters is that one client's data, keyword plans and reports are never shared with another. Ask directly. If an agency offers exclusivity for your town, ask what it costs and how it is enforced, because "we'll only take one therapist in your area" is easy to say and hard to check.

9. What does the first month look like?

A clear answer sounds like a sequence: an intake about your specialties, license and locations; a list of searches matched to pages; fixes to the site and Google profile; then links. Vague answers ("we start optimizing right away") make it hard to know what you are paying for in the first weeks, which is when the most useful fixes usually happen.

10. What will it cost, all in?

Published prices make comparison easy. If an agency quotes only after a sales call, ask for the price in writing, what it includes, and whether there are setup fees. Then weigh it against what a new client is worth to your practice. A simple version: your fee, times sessions a month, times the months a client typically stays. If one new client every few months covers the plan, the decision is easier to make.

A short checklist to send before you sign

Copy these into an email and compare the answers side by side:

Will I approve every page before it is published?
Will you ever contact my clients or ask them for reviews?
Can I see a report outline with every link's live URL listed?
What kinds of sites do the links come from?
Is the domain and Google profile in my name?
How do I cancel, and is there a minimum term?
What do you refuse to do for a practice?
What happens in the first month?
What is the total monthly cost, and are there setup fees?

You will learn as much from how an agency answers as from what it says. Specific, checkable replies in writing are a good sign.

If you would like to see how our answers compare, they are on the pages for SEO for therapists and our plans and fees, and the free visibility review shows where your practice stands today before you commit to anyone.