Use an evidence-first checklist to verify what is ready, what fails, and who owns the fix

This checklist is built for plastic surgery practices preparing a launch, redesign, migration, or structured review of an existing website. It can be used by a solo surgeon, a multi-surgeon group, an internal marketing lead, a developer, or an agency, but each checkpoint should have one accountable owner. The purpose is not to label a site "SEO-ready" from a quick visual review. The purpose is to produce evidence that another person can reproduce.

Evidence required: For every checkpoint, record the affected URL, template, profile, report, configuration, or patient-facing asset, plus the tool or source used to inspect it. Save screenshots or exports where they help establish the baseline.

Pass-fail condition: A pass means the observed live state matches the documented requirement for that checkpoint. A fail means the evidence shows a mismatch, missing control, broken behavior, inaccurate representation, or unvalidated assumption. Mark unknown separately until the required evidence is available.

Severity: Use critical for failures that can block discovery, indexing, secure use, accurate business representation, or responsible publication of patient-facing medical content. Use moderate for problems that reduce clarity, performance, relevance, or maintainability without blocking the primary path. Use low for legitimate housekeeping or enhancement work that can wait.

Owner: Assign technical items to the developer or technical SEO owner, content items to the content lead plus the appropriate clinical reviewer, local items to the verified listings owner, and privacy, claims, testimonial, image, or tracking questions to the relevant qualified reviewers.

Corrective action: Write the exact intended change before implementation. Avoid instructions such as "fix SEO" or "improve schema." State what is wrong, what will change, which pages or templates are affected, and which dependencies or approvals apply.

Validation: Repeat the original test after the change and save the result. A setting change is not proof that the problem is fixed. The checklist item closes only when the public or production behavior passes the same evidence test.

Use the checklist to support launch control and recurring quality reviews, especially after a redesign, template change, CMS update, genuine location change, or major procedure-content revision. Escalate legal, medical, privacy, accessibility, or regulatory questions to the qualified reviewers responsible for the practice.

Priority: Complete launch-blocking technical checks before important pages go live. A technical checkpoint fails because evidence shows an access, indexation, rendering, security, performance, or architecture defect, not because a generic score is imperfect.

Crawlability and indexing

• robots.txt: Evidence required: fetch the live file and test representative practice, surgeon, procedure, and genuine location URLs. Pass: intended public pages are not blocked. Severity: critical if an important page group is unintentionally blocked. Owner: technical SEO and development. Corrective action: change the responsible rule only after confirming intended exclusions. Validation: re-fetch and re-test the same URLs.
• XML sitemap: Evidence required: inspect the live sitemap and Search Console submission. Pass: canonical, indexable public URLs intended for search are represented and return the expected status. Severity: moderate, or critical when the sitemap reflects a larger indexing or migration failure. Owner: technical SEO or development. Corrective action: repair generation or submission. Validation: re-crawl the sitemap and compare with the intended indexable inventory.
• Indexation directives: Evidence required: inspect source and rendered directives plus Search Console for important pages. Pass: no unintended noindex or conflicting canonical state. Severity: critical when core pages are excluded. Owner: development or SEO. Corrective action: fix the responsible template, plugin, header, or page setting. Validation: re-inspect the published URL.
• Internal discovery: Evidence required: crawl from the homepage and key hubs. Pass: important pages are reachable through meaningful internal links and the source checklist's under 3 clicks heuristic can be used as an internal review prompt, not as a Google requirement. Severity: moderate unless orphaning prevents practical discovery. Owner: SEO and information architecture. Corrective action: add or revise contextual navigation. Validation: re-crawl from the same start URL.

Mobile and performance

• Mobile rendering: Evidence required: inspect representative pages on real mobile viewports and browser tools. Pass: primary content, navigation, forms, galleries, and consent controls remain usable. Severity: critical when the patient path is blocked. Owner: design and development. Corrective action: repair the responsive component. Validation: retest the same page states.
• Breakpoint coverage: Evidence required: test the source checklist's 320px, 768px, 1024px reference widths plus relevant real devices. Pass: no clipped, hidden, overlapping, or inaccessible primary content. Severity: moderate or critical according to impact. Owner: design and development. Corrective action: fix the shared layout rule. Validation: repeat the breakpoint test.
• HTTPS: Evidence required: load representative pages and forms over HTTPS and inspect mixed-content warnings. Pass: intended resources load securely. Severity: critical when security warnings or insecure form resources appear. Owner: development or infrastructure. Corrective action: repair certificates, protocols, resources, or redirects. Validation: retest the public page and browser console.
• Core Web Vitals baseline: Evidence required: record available field data and supporting lab diagnostics. Pass or fail should follow the practice's documented current metric policy. The source used LCP <2.5s, CLS <0.1, FID <100ms as an operating reference; do not present those values as a guarantee of rankings. Severity: moderate unless performance blocks important interactions at scale. Owner: development, performance engineering, and content operations. Corrective action: fix the measured bottleneck. Validation: repeat field and lab checks after deployment.

Site architecture

• URL consistency: Evidence required: crawl representative patterns and compare them with the intended information architecture. Pass: URLs are stable, descriptive enough for management, and do not expose unnecessary parameters such as /svc?id=12 for primary landing pages when a clean canonical route is intended. Severity: moderate. Owner: SEO and development. Corrective action: define the preferred route and migration behavior. Validation: crawl final URLs and canonicals.
• Redirects: Evidence required: export redirects for renamed or migrated pages. Pass: permanent moves use appropriate 301 redirects to the most relevant surviving destination without avoidable chains. Severity: critical for important broken migrations, otherwise moderate. Owner: development or technical SEO. Corrective action: repair destination mapping. Validation: crawl old URLs to their final response.
• Duplicate control: Evidence required: crawl canonical tags, duplicate templates, parameters, and indexable variants. Pass: each important intent has a clear preferred URL. Severity: moderate or critical when competing duplicates affect major procedure or location pages. Owner: SEO and development. Corrective action: consolidate, redirect, canonicalize, or change generation logic based on evidence. Validation: re-crawl all affected variants.
• Pagination and facets: Evidence required: inspect crawl paths, canonicals, indexation intent, and internal links. Pass: paginated or faceted states do not create unintended searchable duplication or block discovery of useful content. Severity: moderate. Owner: technical SEO and development. Corrective action: align crawl, link, and canonical behavior with the intended experience. Validation: repeat the crawl and indexation checks.

Priority: Verify core procedure pages before launch and before scaling more content. A page passes when its search intent, patient decision support, clinical accuracy, internal relationships, and conversion path are coherent and reviewable.

Page structure and search intent

• Primary intent: Evidence required: the page brief, search-query data where available, and the live copy. Pass: one main procedure intent is clear and the page does not combine unrelated topics merely to capture more keywords. Severity: moderate. Owner: SEO and content. Corrective action: narrow, split, or consolidate the page. Validation: re-review the live page against the approved intent.
• Heading hierarchy: Evidence required: rendered headings. Pass: the H1 clearly identifies the page topic and H2 sections organize major patient questions without using headings as a keyword-stuffing device. Severity: low to moderate. Owner: content and development. Corrective action: repair hierarchy while preserving accessibility. Validation: inspect the rendered outline.
• Heading depth: Evidence required: section structure and readability review. Pass: the main page heading appears once, and H3 is used only where it improves hierarchy. The source suggested 150-300 words per section as an editorial pacing reference, not a ranking threshold. Severity: low unless poor structure hides essential information. Owner: content. Corrective action: restructure sections around decision questions. Validation: re-read and inspect the heading outline.
• Meta title: Evidence required: live title element and target intent. Pass: the title accurately identifies the procedure and practice without misleading claims. The source used 50-60 characters as a production heuristic, not a search guarantee. Severity: moderate when titles are missing, duplicated, or materially inaccurate. Owner: SEO or content. Corrective action: rewrite accurately. Validation: inspect source and crawl output.
• Meta description: Evidence required: live description and page purpose. Pass: the description summarizes the page accurately without unsupported claims. The source used 120-155 characters as an internal editorial range. Severity: low to moderate. Owner: content or SEO. Corrective action: rewrite to match the live page. Validation: crawl the published metadata.

Body content

• Opening explanation: Evidence required: the first 100 words and the approved clinical brief. Pass: the opening tells a prospective patient what the page covers without making unreviewed candidacy, outcome, or recovery promises. Severity: moderate. Owner: content plus clinical reviewer. Corrective action: rewrite around the actual patient decision task. Validation: compare live copy with the approved source.
• Related procedure links: Evidence required: crawl and manual review. Pass: links connect genuinely related procedures or supporting resources with descriptive anchors. Severity: moderate when important pages are orphaned, otherwise low. Owner: SEO and content. Corrective action: add contextual links where they help the reader. Validation: re-crawl and click-test them.
• Internal-link coverage: Evidence required: crawl the page and inspect destinations. Pass: the source checklist's at least 3 internal links can be used as an internal prompt, but the real pass condition is that the page links to the most useful related destinations without forced or irrelevant links. Severity: low to moderate. Owner: SEO and content. Corrective action: add, remove, or change links based on user usefulness. Validation: re-crawl the final page.
• Structured content inputs: Evidence required: visible information about recovery, pricing where responsibly published, surgeon credentials, and practice context. Pass: statements are accurate, clinically reviewed where appropriate, and not inserted solely for markup. Severity: critical for inaccurate medical or credential claims, otherwise moderate. Owner: content, clinical reviewer, and practice operations. Corrective action: correct or remove unsupported statements. Validation: compare the live page with approved practice records.

Calls to action and trust evidence

• Primary action: Evidence required: mobile and desktop page review. Pass: one clear primary next step is visible without blocking access to medical information. Severity: moderate when users cannot reach the consultation path. Owner: design, content, and operations. Corrective action: clarify the action and destination. Validation: complete the interaction end to end.
• Secondary action: Evidence required: page journey review. Pass: any secondary action supports evaluation rather than distracting from the primary task. Severity: low. Owner: content and design. Corrective action: simplify or reposition. Validation: retest the page journey.
• Credential presentation: Evidence required: compare displayed certifications, training, memberships, and accreditations with authoritative practice records. Pass: only verifiable credentials are shown near decision points. Severity: critical for false or misleading claims. Owner: practice leadership and content. Corrective action: correct or remove unsupported claims. Validation: verify the published text against the authoritative record.

Priority: Complete factual entity, patient-facing claim, privacy, and structured-data checks before launch. Structured data is descriptive markup, not proof of legitimacy and not a guaranteed ranking or rich-result mechanism.

Structured data implementation

• Business entity markup: Evidence required: rendered structured data plus the visible business information. Pass: LocalBusiness, MedicalBusiness, or another applicable type represents the real entity and matches visible name, address, phone, hours, website, and genuine locations or service information. Severity: moderate for markup errors, critical when the visible business data itself is wrong. Owner: technical SEO and development. Corrective action: use the most accurate applicable type and properties. Validation: parse the live markup and compare it with visible content.
• FAQ content: Evidence required: visible questions and answers plus any existing markup. Pass: FAQ content is useful and accurate. Do not add or change schema under this contract, and do not claim FAQPage markup can earn a Google FAQ rich result. Severity: low for markup issues unless they reflect inaccurate medical content. Owner: content, clinical review, and technical SEO. Corrective action: fix the content or implementation according to the approved page. Validation: compare rendered content and markup.
• Review markup: Evidence required: visible review source, eligibility, current markup, and platform policy. Pass: any AggregateRating representation is supported by eligible visible content and current guidelines. The source mentioned a minimum 5 verified reviews as a recommendation; preserve it only as a historical source prompt, not a Google requirement. Severity: moderate to critical for fabricated or ineligible review data. Owner: technical SEO, reputation owner, and legal or policy reviewer where needed. Corrective action: remove unsupported markup or correct the underlying data. Validation: inspect the live source and visible review context.
• Breadcrumb markup: Evidence required: visible navigation and structured data. Pass: BreadcrumbList markup reflects the actual navigational hierarchy. Severity: low. Owner: development or technical SEO. Corrective action: align markup with visible breadcrumbs. Validation: parse the live page.
• Video markup: Evidence required: visible embedded video, metadata, ownership, and any patient authorization required for the content. Pass: VideoObject data describes the actual video without adding unsupported claims. Severity: moderate, or critical when patient privacy or authorization is implicated. Owner: content, technical SEO, and qualified reviewers. Corrective action: correct metadata or remove unapproved patient-facing media. Validation: compare the live video, approval record, and markup.

Patient-facing privacy and claims controls

• Testimonials: Evidence required: the published testimonial, authorization record, and current review or endorsement policy. Pass: the practice has a documented basis for publication and the testimonial is not edited or framed misleadingly. Do not assume a naming format by itself makes a testimonial compliant. Severity: critical when authorization, accuracy, or privacy is unresolved. Owner: legal, privacy, marketing, and practice leadership. Corrective action: remove or revise unapproved material. Validation: compare the live content with the approved record.
• Before-after media: Evidence required: image files, authorization, page context, and metadata inspection. Pass: publication is authorized, identifying data is handled appropriately, and alt text does not expose patient identity. Severity: critical for privacy or authorization failures. Owner: privacy, clinical, content, and media operations. Corrective action: remove identifying metadata or unapproved media and reprocess assets. Validation: re-inspect both the file and live page.
• Privacy information: Evidence required: the live privacy notice and the actual data flows used by forms, analytics, scheduling, call tracking, and third-party services. Pass: the notice and operational practices have been reviewed by qualified privacy personnel and do not make unsupported compliance claims. Severity: critical when actual data handling conflicts with approved practice policy. Owner: privacy, legal, security, and operations. Corrective action: fix the data flow and related notice as directed by qualified reviewers. Validation: repeat the data-flow and public-notice review.
• Educational and outcome language: Evidence required: procedure-page claims, disclaimers, substantiation, and clinical review. Pass: educational statements, risks, recovery information, and result language match the approved evidence and do not imply guaranteed individual outcomes. Severity: critical for unsupported medical or outcome claims. Owner: clinical, legal, regulatory, and content reviewers. Corrective action: remove or rewrite unsupported claims. Validation: compare live copy with the approved source.
• Recovery examples: Evidence required: the clinical source supporting any time range. Pass: a statement such as the source example of 7-10 days appears only when the practice's qualified reviewers have approved the context and limitations. Severity: critical when a recovery range is presented as a guaranteed patient outcome. Owner: clinical and content. Corrective action: qualify, source, or remove the statement. Validation: re-review the published language against the approved clinical source.

Priority: Verify galleries before launch and after any media-processing or template change. The source repeated LCP under 2.5s, CLS under 0.1, and FID under 100ms as performance references. Keep those values as historical operational thresholds, not as guarantees of rankings, patient trust, or clinical quality.

Technical image setup

• Format and compression: Evidence required: network transfer data and source files for representative gallery assets. Pass: the browser receives an efficient supported format and image quality remains suitable for responsible patient education. The source cited 40-60% file-size reduction versus JPEG as an example, not a guaranteed saving. Severity: moderate when image payload materially harms important pages. Owner: development and media operations. Corrective action: recompress or re-encode based on measured files. Validation: compare transfer size, visual quality, and page rendering after deployment.
• Lazy loading: Evidence required: rendered HTML and network behavior. Pass: offscreen media loads in a way that does not hide important content from users or search systems. Severity: moderate. Owner: development. Corrective action: repair loading behavior and prioritize the actual largest above-the-fold content where appropriate. Validation: test scrolling, rendering, and network requests.
• Responsive dimensions: Evidence required: CSS, intrinsic image dimensions, and mobile or desktop rendering. Pass: images do not overflow their containers and the source's max-width 100% and 600px desktop examples are treated as implementation references rather than universal requirements. Severity: moderate when layout or payload is affected. Owner: design and development. Corrective action: deliver appropriate dimensions and styling for the template. Validation: inspect representative viewport sizes.
• Responsive sources: Evidence required: srcset or equivalent responsive delivery plus network inspection. Pass: devices receive appropriately sized assets without unnecessary transfer. Severity: moderate. Owner: development or image pipeline owner. Corrective action: generate and serve suitable variants. Validation: confirm chosen resource sizes on representative devices.

SEO and privacy-aware metadata

• Alt text: Evidence required: the live image, surrounding content, and accessibility review. Pass: alt text communicates the image's purpose without unnecessary patient identifiers. The source example included a 58-year-old person and 6 weeks post-op; preserve those numbers as an example requiring responsible review, not a template to copy across patients. Severity: critical if identifying information is inappropriately exposed, otherwise moderate or low. Owner: content, accessibility, privacy, and clinical reviewers as appropriate. Corrective action: rewrite alt text for purpose and privacy. Validation: inspect the live accessibility tree and page source.
• Filename: Evidence required: delivered asset names and media library. Pass: filenames are manageable and do not expose patient identity or sensitive information. The source example facelift-before-after-58yf-6weeks.jpg and generic img_001.jpg illustrate naming differences, not a ranking formula. Severity: moderate for privacy exposure, otherwise low. Owner: media operations and development. Corrective action: rename or regenerate assets when appropriate. Validation: confirm the delivered public filename and cache behavior.
• EXIF data: Evidence required: inspect downloaded public image files. Pass: location, device, date, or other metadata is removed when it is not intended for publication. Severity: critical when metadata exposes sensitive information, otherwise moderate. Owner: media operations and privacy. Corrective action: strip or sanitize metadata before upload. Validation: download and inspect the published file again.
• Gallery headings: Evidence required: rendered page outline. Pass: the gallery has one clear H1 and supporting H2 structure where appropriate, with headings that describe visible content rather than stuffing search terms. The source examples used H1 and H2 labels. Severity: low unless the structure obscures key information or duplicates page intent. Owner: content and development. Corrective action: repair the heading hierarchy. Validation: inspect the rendered outline.

Priority: Establish a production baseline and keep evidence for changes over time. Monitoring is useful only when someone owns the alert, understands the metric, and can validate the repair.

Performance baseline

• LCP: Evidence required: field data where available, supported by lab diagnostics. Pass: assess against the practice's current performance policy; the source used <2.5 seconds as its reference. Severity: moderate or critical when poor loading blocks important content. Owner: performance engineering and development. Corrective action: optimize the measured largest-content bottleneck. Validation: repeat field and lab measurement.
• CLS: Evidence required: real-user or representative session data. Pass: the source used <0.1 as its reference, while the practical requirement is that layout instability does not interfere with reading or interaction. Severity: moderate. Owner: design and development. Corrective action: reserve dimensions and fix unstable components. Validation: remeasure the affected template.
• FID and INP: Evidence required: current field responsiveness data. Pass: the source used FID <100ms and advised monitoring INP when FID is unavailable. Treat the historical FID value as preserved source context, not a current universal ranking promise. Severity: moderate when interaction delay harms forms or navigation. Owner: development. Corrective action: reduce main-thread and interaction bottlenecks. Validation: remeasure with current field data.
• Mobile loading: Evidence required: representative network testing and field data. Pass: the source used under 3 seconds on 4G mobile as an internal target; use it as a historical benchmark while diagnosing the actual patient experience. Severity: moderate or critical when essential content or booking functions are delayed. Owner: development and performance engineering. Corrective action: reduce transfer, defer non-critical JavaScript, improve caching or delivery where justified. Validation: repeat the same network test.
• Availability: Evidence required: hosting records and an independent uptime monitor. Pass: compare actual availability with the contracted service level. The source used a 99% uptime SLA example, which is a hosting target rather than an SEO guarantee. Severity: critical when outages prevent access to the practice website. Owner: infrastructure or hosting provider. Corrective action: address the failure source and escalation path. Validation: confirm recovery and monitor recurrence.

Recurring audit cadence

• Performance review: Evidence required: current field trends and Search Console signals. Pass: material regressions have an assigned owner and investigation. Severity follows impact. Corrective action: diagnose the affected template or deployment. Validation: confirm the trend after the repair.
• Technical crawl: Evidence required: crawl comparison against the prior baseline. Pass: new errors, redirects, canonicals, indexation directives, and mobile issues are either resolved or intentionally documented. Owner: technical SEO. Corrective action: assign each regression. Validation: rerun the crawl.
• On-page review: Evidence required: representative core pages. Pass: H1/H2 structure, page intent, internal links, credentials, and clinical-review status remain aligned with the live practice. Owner: content and clinical review. Corrective action: revise changed or stale content. Validation: compare published pages with the approved source.
• Gallery review: Evidence required: public image files, alt text, metadata, loading behavior, and authorization records. Pass: technical and privacy controls remain intact. Owner: media, content, privacy, and development. Corrective action: reprocess or remove failed assets. Validation: inspect the live gallery and downloaded files.
• Structured-data review: Evidence required: live markup and visible content. Pass: structured data still matches the page and current implementation policy. Owner: technical SEO and development. Corrective action: update only what the visible entity and content support. Validation: parse the live output and compare it with the page.

Keep the audit record in an owned change log or shared tracker with dates, evidence, severity, owner, action, and validation status. The cadence should follow change risk and operational capacity rather than being presented as a guaranteed ranking schedule.