A Dermatology SEO Checklist Built for Verification, Not Guesswork

This checklist is for dermatology practice owners, administrators, marketing coordinators, and external partners who need a practical way to inspect search visibility work without accepting vague status reports. It can also be used to evaluate whether an agency scope covers the basics that matter for a real practice.

Use the same method for every item: capture the evidence, mark the pass or fail condition, record severity, assign an owner, complete the corrective action, and repeat the validation. A pass means the observable condition is satisfied; it does not mean Google will rank the page or that a marketing outcome is guaranteed.

The source described this as suitable for single and multi-location dermatology practices with 1-5 offices. That range is an operating context, not a qualification rule. Larger organizations can still use the checks, but governance, security, analytics, and location management usually require additional controls.

This checklist is educational and operational guidance. It cannot guarantee compliance, and responsible legal, medical, or regulatory reviewers remain required for privacy, advertising, consent, clinical accuracy, and jurisdiction-specific decisions.

Step 1: Verify Google Business Profile control and core practice facts.

• Evidence required: Admin access at business.google.com, the live profile, the practice website, current office hours, primary phone, address, categories, service information, and approved images.
• Pass condition: The profile represents the real dermatology practice or location, the practice controls access, and the visible facts match approved operational records.
• Fail condition: Access is unclear, a duplicate or closed profile is being used, material business facts are wrong, or the profile describes services the location does not provide.
• Severity: High when patients can be misdirected or the practice cannot control its listing; otherwise medium.
• Owner: Practice administrator with support from the local marketing owner.
• Corrective action: Resolve ownership, correct factual fields, and replace unsupported or outdated content. The source previously suggested 10-15 photos; treat that as an inventory example, not an official ranking quota.
• Validation: Reopen the public profile and compare each visible fact with the approved source of truth.

Step 2: Reconcile name, address, and phone information across important listings.

• Evidence required: A citation inventory covering the practice website, Google Business Profile, Apple Maps, Yelp, Healthgrades, Vitals, ZocDoc, relevant hospital or association directories, and any other listing that patients actually encounter.
• Pass condition: Each listing identifies the same real practice or location and uses accurate contact information. Formatting can vary when the underlying address remains unambiguous.
• Fail condition: A listing points to the wrong location, uses a disconnected phone number, duplicates the same location improperly, or contains a materially different practice name.
• Severity: High for wrong contact or location data; medium for lower-risk inconsistencies.
• Owner: Local listings owner or practice administrator.
• Corrective action: Update inaccurate records and document unresolved publisher limitations. A ZIP format such as 90210 versus 90210-1234 should be checked for factual accuracy rather than assumed to create a ranking penalty by itself.
• Validation: Recheck the edited listings after publication and confirm that patients are routed to the correct office.

Step 3: Capture a local visibility baseline before changing strategy.

• Evidence required: Export or screenshot the available Google Business Profile performance data and save the reporting period, location, and definitions used. Pair those records with the relevant metric definitions used internally.
• Pass condition: The practice has a dated baseline that can be compared with the same data source later.
• Fail condition: Teams discuss improvement without preserving the original period, metric definition, or location scope.
• Severity: Medium because poor baselines weaken decision quality even when they do not affect ranking directly.
• Owner: Analytics or marketing owner.
• Corrective action: Save the current report before additional optimization.
• Validation: Compare the same metric definitions again in 60 days, while noting seasonality, campaigns, profile changes, and other factors that can affect interpretation.

Step 1: Confirm which procedure pages correspond to real services.

• Evidence required: The approved service list, provider scope, location availability, navigation, indexed URLs, and current page inventory.
• Pass condition: Each important service has a clear destination when a dedicated page is useful, and the page accurately states where and by whom the service is offered.
• Fail condition: Important services are buried on a generic page, duplicate pages compete for the same purpose, or content advertises care that the named location does not provide.
• Severity: High for misleading service availability; medium for architecture gaps.
• Owner: Content lead with clinical and practice operations review.
• Corrective action: Consolidate duplicates, create or improve only the pages justified by real services and patient needs, and define the primary purpose of each page.
• Validation: Review the published navigation and page set against the approved service inventory.

Step 2: Inspect the search-facing elements and patient usefulness of each procedure page.

• Evidence required: Rendered page, HTML source, search-console query data when available, and approved clinical copy.
• Pass condition: The title is descriptive and concise; the source used 60 characters as an editorial ceiling, not a Google ranking rule. The meta description accurately summarizes the page; the source used 120-155 characters as a writing range, not a guaranteed display length. The page has a clear H1 and uses headings to organize content. One H1 may be a reasonable site convention, but heading structure should serve semantics and accessibility rather than a ranking myth. The source used 500-800 words as a prior content range; there is no universal word-count minimum for ranking.
• Fail condition: Titles or descriptions misstate the service, the page is thin relative to the decision it must support, or clinical statements are copied without review.
• Severity: High for inaccurate medical or service claims; medium for weaker search alignment.
• Owner: SEO or content owner, with a qualified clinical reviewer for medical statements.
• Corrective action: Rewrite around the actual service, patient questions, eligibility boundaries, practical next steps, and local availability without promising outcomes.
• Validation: Re-render the page, inspect the HTML, and confirm that every material claim matches approved practice information.

Step 3: Implement structured data only where it accurately describes the page.

• Evidence required: Current JSON-LD or other markup, the visible page content, and the schema vocabulary selected.
• Pass condition: Markup describes facts that are visible or otherwise appropriate to represent and does not invent credentials, outcomes, ratings, or services.
• Fail condition: Markup contradicts the page, creates unsupported entities, or is treated as a guaranteed ranking or rich-result tactic.
• Severity: High for fabricated medical or business facts; low to medium for non-material markup errors.
• Owner: Technical SEO or developer, with content-owner verification.
• Corrective action: Remove unsupported properties and keep only accurate, relevant markup.
• Validation: Run a structured-data validator and compare the parsed fields against the visible page and approved source data.

Structured data can help machines interpret entities and page context, but it does not guarantee rankings, Google AI Overview inclusion, featured snippets, carousels, or any other search feature. Treat it as a data-quality task: the markup must match the practice and the page.

1. MedicalBusiness. Evidence required: Approved organization name, location, contact details, and any other properties actually used. Pass: the markup represents the real dermatology organization and matches visible business facts. Fail: credentials, licenses, services, or locations are invented. Severity: high for fabricated facts. Owner: developer or technical SEO. Correction: remove or correct unsupported properties. Validation: compare parsed output with approved practice records.

2. MedicalProcedure. Evidence required: The procedure page and clinically reviewed statements about what the service is, why it may be considered, material risks, and recovery time when the practice has an approved basis to publish them. Pass: markup does not say more than the page can support. Fail: it encodes unreviewed outcomes or medical claims. Severity: high. Owner: technical implementer plus clinical content reviewer. Correction: align markup to approved page content. Validation: compare each property with the final rendered copy.

3. LocalBusiness. Evidence required: Correct public business facts for the genuine location. Pass: location and contact details match the site and approved records. Fail: a nominal service area is represented as a staffed location or the markup points to stale contact details. Severity: high when patients could be misdirected. Owner: developer and local listings owner. Correction: use only genuine location data. Validation: reconcile the markup against the live location page and business profile.

Implementation check: If a website platform supplies templates, inspect the generated output rather than assuming it is correct. For custom work, use schema.org vocabulary as appropriate and validate syntax with Google's Rich Results Test. Passing a validator confirms syntax or eligibility checks only; it does not promise visibility or a rich result.

Step 1: Build an honest review invitation workflow.

• Evidence required: Written eligibility rule, invitation copy, delivery method, destination profile, opt-out handling where applicable, and records showing the same policy is applied without sentiment screening.
• Pass condition: Eligible patients are asked consistently for honest feedback without incentives tied to review content, discouraging negative feedback, or selecting only satisfied patients.
• Fail condition: Staff gate requests by satisfaction, offer compensation for favorable reviews, or use language that pressures the patient to post a positive rating.
• Severity: High because review practices can create policy, trust, and regulatory risk.
• Owner: Practice operations with legal or compliance review as appropriate.
• Corrective action: Standardize neutral invitation language and remove gating or reward conditions. The prior source cited a 5-10x difference from systematic requests and a day 3-7 send window, but no supporting source URL appears in this file; treat both as historical operating observations, not ranking rules or guaranteed conversion effects.
• Validation: Sample recent invitations and confirm that eligibility and wording were applied consistently.

Step 2: Monitor reviews and use privacy-aware response rules.

• Evidence required: Response policy, approved templates, escalation path, and a sample of public replies.
• Pass condition: Replies avoid confirming a reviewer is a patient, avoid discussing treatment or other protected details, and move sensitive resolution into an approved private channel.
• Fail condition: A reply reveals or confirms health information, argues clinical facts in public, or treats response speed as an official Google ranking formula.
• Severity: Critical for potential privacy disclosure; otherwise medium.
• Owner: Trained practice representative with escalation to the privacy or compliance owner.
• Corrective action: Replace risky reply scripts with neutral acknowledgments and a private escalation path. A 48 hours positive-response target and 72 hours negative-response target can be internal service levels, but they are not documented ranking thresholds.
• Validation: Audit a sample of replies for privacy-safe wording and policy consistency.

Step 3: Track review operations without turning a quota into a ranking claim.

• Evidence required: Current review count, rating, invitation volume, platform issues, and qualitative themes.
• Pass condition: The practice can explain how feedback is requested and monitored without using a fabricated ranking quota.
• Fail condition: Teams promise visibility from a fixed review count or pressure staff to suppress unfavorable feedback.
• Severity: Medium, rising to high if incentives or gating are involved.
• Owner: Practice operations.
• Corrective action: Use process-quality measures instead of ranking promises. The source used 1-2 new reviews per week per office location as a target; treat it as a historical capacity example, not an official Google requirement.
• Validation: Review the invitation policy and monthly records together to confirm consistent, neutral execution.

Technical checks should answer two questions: can search systems access and interpret the important pages, and can patients use them safely and efficiently? Treat each test as evidence, not as a standalone ranking guarantee.

Step 1: Test real-user performance and page weight.

• Evidence required: Mobile and desktop diagnostics from pagespeed.web.dev, field data when available, a network waterfall, and the largest media assets.
• Pass condition: Material performance defects are identified and the important patient paths remain usable. The source used 75+ as an internal score target; do not treat that score as a Google ranking threshold. It also suggested 100-200 KB per image as an operational budget, which can be useful for triage but is not a universal requirement.
• Fail condition: Large assets, blocking scripts, layout instability, or other defects materially delay or disrupt core tasks.
• Severity: High when appointment or contact paths are impaired; otherwise medium.
• Owner: Developer or web performance owner.
• Corrective action: Compress appropriately, resize media, defer non-critical code where safe, and retest the same pages.
• Validation: Re-run the diagnostics and verify the affected interactions on representative devices.

Step 2: Inspect mobile usability.

• Evidence required: Representative device tests, browser checks, zoom behavior, form usability, navigation, and tap-target review.
• Pass condition: Core content and actions are readable and operable without accidental taps. The source used 44x44px as a UI target; treat it as a design check, not a blanket legal or ranking standard.
• Fail condition: Text is unreadable, controls overlap, forms break, or essential actions cannot be completed on common mobile layouts.
• Severity: High for broken patient tasks.
• Owner: Front-end developer or web vendor.
• Corrective action: Repair responsive layout and interaction defects.
• Validation: Repeat the same task-based tests after deployment.

Step 3: Verify HTTPS and secure page delivery.

• Evidence required: Browser security status, certificate configuration, redirects, and form endpoints.
• Pass condition: Public pages and patient-facing forms load through HTTPS without mixed-content or certificate errors.
• Fail condition: Sensitive submissions are exposed to insecure transport or users receive certificate warnings.
• Severity: Critical for insecure patient-facing submissions.
• Owner: Hosting or development owner.
• Corrective action: Correct certificate, redirect, and mixed-content issues.
• Validation: Test representative URLs and forms after the fix.

Step 4: Review analytics and privacy data flows.

• Evidence required: Tag inventory, event parameters, URLs, form behavior, vendor contracts, data destinations, retention settings, and documented privacy decisions.
• Pass condition: The practice has assessed whether protected or sensitive health information can enter analytics or advertising tools and has implemented controls approved by its responsible reviewers. Whether a HIPAA Business Associate Agreement is required or sufficient depends on the actual vendor role and data flow; do not assume a tool is compliant merely because a contract exists.
• Fail condition: Patient names, conditions, appointment details, or other sensitive data are transmitted without an approved basis, or no one can explain what data leaves the site.
• Severity: Critical when sensitive health data may be exposed.
• Owner: Privacy or compliance owner with technical support.
• Corrective action: Minimize transmitted data, remove sensitive parameters, revise tags or forms, and complete the appropriate vendor and legal review.
• Validation: Inspect live network requests and event payloads after remediation.

Step 5: Verify crawl and index controls.

• Evidence required: XML sitemap, robots.txt, canonical signals, important page status codes, and Google Search Console coverage information.
• Pass condition: Important public pages are discoverable and not accidentally blocked, while private or non-public resources remain appropriately restricted.
• Fail condition: robots.txt, noindex directives, redirects, or broken status codes prevent intended pages from being crawled or indexed.
• Severity: High when important pages are excluded unintentionally.
• Owner: Technical SEO or developer.
• Corrective action: Repair the relevant directive, sitemap entry, canonical, redirect, or status code.
• Validation: Re-crawl the affected URLs and confirm the intended indexability state.

Procedure pages can support search visibility only when they accurately represent what the dermatology practice offers and help patients understand the next decision. The source included several editorial length and outcome examples; preserve them as historical drafting references, not as ranking thresholds or clinical claims.

H1 and page purpose. Evidence required: approved service name, genuine location availability, and the rendered heading. Pass: the heading states what the page is about without exaggeration. Fail: the page promises an outcome or advertises a service the location does not offer. Severity: high for misleading claims. Owner: content lead. Correction: align the heading to the real service. Validation: compare it with the approved service inventory.

Introductory copy. The prior template suggested 50-100 words. Evidence required: patient-question research and approved service description. Pass: the opening gives a clear, non-promissory orientation. Fail: it overstates candidacy, safety, or expected benefit. Severity: high for clinical overstatement. Owner: content lead plus clinical reviewer. Correction: replace promotional certainty with accurate, patient-relevant context. Validation: clinical signoff and final-page review.

Service explanation. The prior template suggested 150-200 words. Evidence required: current practice materials and clinically appropriate sources selected by the reviewer. Pass: the explanation is understandable and accurate. Fail: copied or generic text conflicts with the way the practice actually delivers care. Severity: high. Owner: clinical content reviewer and editor. Correction: rewrite for the practice and patient audience. Validation: compare the published version with the approved draft.

Candidate or suitability discussion. The prior template suggested 100-150 words. Evidence required: clinician-approved boundaries on who may be evaluated for the service. Pass: the page avoids diagnosing the reader and directs individualized decisions to a qualified clinician. Fail: demographic traits or symptoms are presented as automatic eligibility. Severity: critical when a reader could mistake marketing copy for personal medical advice. Owner: clinical reviewer. Correction: state that suitability requires individual assessment. Validation: reviewer approval.

Appointment process. The prior template suggested 200-300 words. Evidence required: actual workflow from the practice. Pass: the page describes typical administrative and procedural steps without guaranteeing discomfort, recovery, or outcome. Fail: the copy promises a uniform experience. Severity: high for inaccurate clinical expectations. Owner: practice operations plus clinical reviewer. Correction: align the description to real workflow and appropriate uncertainty. Validation: staff walkthrough against current operations.

Results and timing claims. The prior template suggested 100-150 words. The prior draft included an example stating 50% at day 3, full results at day 7-10, and duration of 3-4 months. No supporting source URL appears in this file. Evidence required: clinically appropriate evidence and reviewer approval for any result or timing statement. Pass: only substantiated, appropriately qualified information is published. Fail: the historical example is published as a guaranteed patient outcome. Severity: critical. Owner: responsible clinical reviewer. Correction: verify, qualify, or remove unsupported outcome language. Validation: documented clinical approval before publication.

Aftercare guidance. The prior template suggested 100-150 words and used 24 hours as an example restriction period. Evidence required: practice-approved patient instructions for the specific service. Pass: public copy matches current instructions and clearly identifies situations requiring direct clinical contact. Fail: generic internet guidance is substituted for practice instructions. Severity: critical when incorrect guidance could affect care. Owner: clinical reviewer. Correction: publish only approved general education and direct individualized questions to the practice. Validation: compare with current patient materials.

FAQs. The prior template suggested 4-6 questions. Evidence required: recurring patient questions, approved answers, and a check that the content is not duplicative. Pass: answers are useful, accurate, and do not imply that FAQ markup itself earns a Google search feature. Fail: FAQs are added solely to manipulate search presentation or contain unreviewed medical advice. Severity: high for clinical inaccuracies. Owner: content owner plus clinical reviewer. Correction: rewrite around genuine patient decisions. Validation: final content and markup review.

Testimonials. The prior template suggested 50-100 words each and 2-3 reviews. Evidence required: documented authorization, advertising-policy review, exact approved text, and any required disclosures. Pass: the practice can substantiate permission and the testimonial is not edited into a misleading outcome claim. Fail: identity details, treatment facts, or results are published without an approved basis. Severity: critical for privacy or deceptive-advertising risk. Owner: compliance or legal reviewer with marketing operations. Correction: remove or revise content that lacks authorization or required context. Validation: compare publication against the signed approval and current rules.

Cost and financing information. The prior template suggested 50-100 words and included $400-$800 per syringe as an illustrative amount. That amount is not verified by a supporting source URL here and should not be presented as the practice's fee without confirmation. Evidence required: current approved fee or financing information for the actual practice. Pass: published amounts and conditions match current policy. Fail: copied prices or financing claims are outdated or misleading. Severity: high. Owner: practice finance or operations lead. Correction: update or remove unsupported pricing. Validation: compare with the current approved fee schedule.

Internal links. Evidence required: rendered page, destination pages, and service relationships. Pass: links help a patient reach genuinely related services or contact information. Fail: links are inserted mechanically, point to irrelevant pages, or imply services unavailable at that location. Severity: medium. Owner: content or SEO owner. Correction: retain only useful, contextual links. Validation: click-test destinations and review anchor wording in context.

PHASE 1: FOUNDATION (WEEKS 1-2)

1. Evidence: admin access at business.google.com and live profile facts. Pass: the correct practice controls the profile and public facts are accurate. Fail: ownership or core facts are wrong. Severity: high. Owner: practice administrator. Action: resolve access and correct records. Validate: compare the live profile with approved practice data.
2. Evidence: citation inventory across the directories patients use. Pass: each listing points to the correct practice and location. Fail: stale or duplicate listings misdirect patients. Severity: high. Owner: listings manager. Action: correct material inconsistencies. Validate: recheck published listings.
3. Evidence: website contact information and directory records. Pass: name, address, and phone data are factually aligned. Fail: material differences remain unexplained. Severity: medium. Owner: practice administrator. Action: reconcile the source of truth. Validate: compare live records again.
4. Evidence: approved photo library and public profile gallery. Pass: images are current, authorized, and accurately represent the practice. Fail: images are misleading, unauthorized, or stale. Severity: high for privacy or advertising risk. Owner: marketing and compliance. Action: remove risky media and publish only approved assets. Validate: inspect the public gallery. The prior source suggested 10-15 images as an inventory example, not a ranking quota.
5. Evidence: saved Business Profile performance baseline. Pass: date, location, and metric definitions are recorded. Fail: no comparable baseline exists. Severity: medium. Owner: analytics lead. Action: save the current report. Validate: confirm it can be reproduced later.
6. Evidence: public business description and approved service list. Pass: the description is accurate and not promotional beyond substantiation. Fail: it contains unsupported specialties or availability claims. Severity: high. Owner: content owner. Action: rewrite from approved facts. Validate: compare with the service inventory.

PHASE 2: ON-PAGE (WEEKS 3-4)

1. Evidence: current service and URL inventory. Pass: the site's core 5-10 procedure priorities correspond to real services and patient demand. Fail: pages are chosen from a generic template or advertise unavailable care. Severity: high. Owner: practice and content lead. Action: prioritize genuine services. Validate: reconcile with operations.
2. Evidence: Search Console data, patient questions, and local search observations. Pass: each page has a clear query and decision purpose. Fail: keyword choices ignore the actual service or patient intent. Severity: medium. Owner: SEO lead. Action: revise the targeting brief. Validate: compare page purpose with observed queries.
3. Evidence: title, meta description, and H1 for each priority page. Pass: elements are descriptive, accurate, and useful. Fail: they are duplicated, misleading, or stuffed with terms. Severity: medium. Owner: content owner. Action: rewrite. Validate: inspect rendered HTML and search snippets when available.
4. Evidence: final procedure copy and reviewer notes. Pass: the page answers material patient questions accurately. The prior source used 500-800 words as an editorial range, not a ranking minimum. Fail: length is used as a substitute for usefulness or clinical review. Severity: high for medical inaccuracies. Owner: editor and clinical reviewer. Action: improve substance, not word count. Validate: reviewer signoff.
5. Evidence: structured data and visible page facts. Pass: markup accurately describes the page. Fail: unsupported services, ratings, credentials, or outcomes are encoded. Severity: high. Owner: developer. Action: remove unsupported properties. Validate: parse and compare with the page.
6. Evidence: validator output. Pass: syntax is valid and applicable properties match visible facts. Fail: errors or factual conflicts remain. Severity: medium. Owner: developer. Action: correct the markup. Validate: rerun Google's Rich Results Test without assuming a passed test guarantees a feature.
7. Evidence: internal link map and destination pages. Pass: links connect genuinely related services and patient next steps. Fail: links are irrelevant, broken, or mechanically inserted. Severity: medium. Owner: content or SEO lead. Action: repair and simplify. Validate: crawl and click-test destinations.

PHASE 3: REVIEWS (WEEKS 5-8)

1. Evidence: neutral review invitation template. Pass: eligible patients are asked consistently for honest feedback. Fail: wording asks only happy patients or conditions a benefit on positive content. Severity: high. Owner: operations. Action: remove gating and incentives tied to sentiment. Validate: sample sent messages.
2. Evidence: SMS workflow configuration and vendor data handling review. Pass: messaging follows the approved invitation policy and privacy rules. Fail: sensitive information is placed in messages or an unreviewed vendor flow. Severity: high. Owner: operations and privacy lead. Action: minimize data and correct the workflow. Validate: inspect a test message and transmission path.
3. Evidence: assigned reviewer-monitoring role and response policy. Pass: ownership and escalation are clear. Fail: no one monitors privacy-sensitive public responses. Severity: high. Owner: practice manager. Action: assign responsibility. Validate: review recent responses.
4. Evidence: baseline count, rating, and themes. Pass: the baseline is dated and reproducible. Fail: teams rely on memory or screenshots without context. Severity: medium. Owner: analytics lead. Action: document current state. Validate: reproduce the figures from the platform.
5. Evidence: monthly operating goal and invitation capacity. Pass: the goal supports consistent honest requests without ranking promises. The source used 4-6 new reviews per location as an example goal, not an official Google requirement. Fail: staff are pressured to manipulate sentiment or guarantee visibility. Severity: high. Owner: operations. Action: replace ranking quotas with process-quality goals. Validate: audit the request policy and sample invitations.

PHASE 4: TECHNICAL (WEEKS 6-8)

1. Evidence: mobile performance report from pagespeed.web.dev. Pass: material defects are understood and prioritized. The source used 75+ as an internal score target, not a ranking threshold. Fail: the team optimizes a score without checking patient tasks. Severity: medium to high. Owner: developer. Action: fix material bottlenecks. Validate: retest the same pages.
2. Evidence: image inventory and transfer sizes. Pass: images are appropriately compressed for their visual role. The source used 200 KB as an operating ceiling, not a universal requirement. Fail: oversized media delays core pages. Severity: medium. Owner: developer or content producer. Action: resize and compress. Validate: remeasure transfer size and quality.
3. Evidence: representative iPhone and Android task tests. Pass: navigation, forms, and contact actions work across tested layouts. Fail: core interactions break. Severity: high. Owner: front-end developer. Action: repair responsive defects. Validate: repeat the same tasks.
4. Evidence: certificate and browser security checks. Pass: all public and form pages use HTTPS without certificate warnings. Fail: insecure transport or mixed content remains. Severity: critical for sensitive submissions. Owner: hosting or development owner. Action: fix certificate and redirect configuration. Validate: retest representative pages.
5. Evidence: analytics data-flow map, vendor terms, and privacy review. Pass: the practice understands what data is sent and has approved safeguards. Fail: sensitive health data can enter analytics without a reviewed basis. Severity: critical. Owner: privacy lead and developer. Action: minimize data and correct vendors or tags as required. Validate: inspect network requests.
6. Evidence: XML sitemap and Search Console state. Pass: intended public pages are represented and discoverable. Fail: important URLs are omitted or stale URLs dominate. Severity: medium. Owner: technical SEO. Action: regenerate and submit an accurate sitemap. Validate: compare submitted URLs with the canonical page inventory.
7. Evidence: robots.txt and page directives. Pass: important public directories are not blocked unintentionally. Fail: crawl controls conflict with the intended index state. Severity: high. Owner: technical SEO or developer. Action: correct directives. Validate: recrawl affected URLs.

PHASE 5: MEASUREMENT (ONGOING)

1. Evidence: verified Google Search Console property and defined query/page reports. Pass: the practice can inspect impressions, clicks, queries, and indexing without treating one metric as proof of patient acquisition. Fail: reports mix unrelated sites or periods. Severity: medium. Owner: analytics lead. Action: correct property and reporting scope. Validate: reproduce the report.
2. Evidence: Business Profile performance reports. Pass: the team uses stable definitions and documented periods. Fail: changes are attributed to SEO without considering campaigns, seasonality, or platform changes. Severity: medium. Owner: local marketing lead. Action: annotate context. Validate: compare equivalent periods.
3. Evidence: practice-approved new-patient measurement method. Pass: the team can distinguish inquiry source from booked and completed care where policy permits. Fail: traffic is treated as revenue or clinical volume without attribution controls. Severity: high for decision-making. Owner: analytics and operations. Action: document definitions and source capture. Validate: reconcile sampled records.
4. Evidence: page-level traffic and conversion events that have passed privacy review. Pass: the practice can identify which service pages assist inquiries without collecting unnecessary sensitive data. Fail: events leak health details or cannot be tied to a defined business question. Severity: critical for privacy, otherwise medium. Owner: analytics and privacy leads. Action: redesign events and reports. Validate: inspect payloads and report logic.
5. Evidence: documented review at month 3 and month 6 using the same baselines and definitions. Pass: changes are evaluated by stage and context. The prior source expected ranking improvement in months 3-4; treat that as a historical expectation, not a guarantee. Fail: the practice declares success or failure from a single snapshot. Severity: medium. Owner: marketing lead. Action: compare like-for-like periods and document confounders. Validate: repeat the analysis with preserved source data.