A step-by-step framework you can audit this week — prioritized by what moves the needle first

Below is the structured breakdown organized by category. Each item is tagged 'Quick Win,' 'High Impact,' 'Foundational,' or 'Ongoing' so you can prioritize your sprint.

Technical Foundation (8 items): Site speed, mobile usability, indexing, Core Web Vitals, GZIP compression, lazy loading, XML sitemaps, robots.txt.

On-Page Optimization (9 items): Page titles, meta descriptions, H1 tags, service page copy uniqueness, keyword research, internal linking, schema markup, header hierarchy, image alt text.

Local SEO (12 items): GBP claim and verification, GBP photos, GBP posts, business hours accuracy, review requests, review responses, citation consistency (Yelp, Healthgrades, etc.), local backlinks, multi-location pages, local structured data, Google Posts frequency, service area configuration.

Compliance and Trust (10 items): Before-and-after consent audit, testimonial disclaimers, medical claims verification, state board advertising rules, HIPAA privacy policy, FTC compliance checklist, competitor compliance benchmark, content moderation policy, legal review frequency, staff training on compliant claims.

Reputation and Review Management (8 items): Review monitoring setup, GBP review response rate, review request frequency, negative review response protocol, review dashboard, rating trend analysis, Yelp profile optimization, third-party review site audits.

Download the full checklist PDF below with all 47 items, prioritization tags, and implementation notes.

The PDF version of this checklist includes:

• All 47 items with prioritization tags (Quick Win, High Impact, Foundational, Ongoing)
• Implementation notes and estimated time for each item
• Responsible owner field (for teams: who does this?)
• Completion date and status tracking
• Links to compliance resources and state-specific medical board guidelines

Use this to build your sprint plan, share with your team, or hand to an agency for evaluation.

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After downloading, share it with your team and set a 30-day goal for the quick wins section. Most practices report 20–30% of the quick wins are already done; the other 30–50% take 1–3 hours each to complete.

Completing this checklist yourself is possible, but some items are time-intensive or require specialized expertise. Know when to outsource.

Hire an agency if:

• Your site has technical debt (years of bloat, outdated platform). An audit and rebuild takes specialist time.
• Your current rankings are flat or declining. Competitive issues often need external research and strategy—you're too close to see them.
• You lack an in-house developer or marketing coordinator. The checklist assumes someone owns ongoing implementation and monitoring.
• Compliance is complex. Multi-location practices, practices with complex medical claims, or practices in highly regulated states benefit from professional compliance audits.
• You're ready to invest beyond 'fixing basics.' If you want to compete for high-volume keywords and rank in the Google Map Pack consistently, hire an agency experienced with medical spas.

You can handle it in-house if:

• Your site is modern and relatively clean (built in the last 3–4 years).
• You have bandwidth—20 hours per month for 3–6 months.
• Your market has low to moderate SEO competition (small towns often do).
• You're comfortable with technical basics (Google Search Console, basic HTML, Google Analytics).

Most medical spas fall somewhere in the middle: they can handle the quick wins, but outsource the high-impact and foundational work.