A Step-by-Step SEO Audit Framework Built for Physical Therapy Practices

This guide is written for physical therapy practice owners, clinic directors, and office managers who want a clear-eyed answer to one question: why isn't our website generating more patient inquiries from search?

You don't need to be technical to complete this audit. You do need access to a few free tools — Google Search Console, Google Analytics (or GA4), and Google's PageSpeed Insights — plus about two to three hours of focused time.

This guide is most useful if any of the following apply to your practice:

• You've had a website for more than a year but can't point to consistent organic traffic or patient leads from search.
• You recently redesigned your site and noticed a drop in visibility afterward.
• A competitor clinic in your area appears above you in Google Maps or organic results for searches you should be winning.
• You're preparing to invest in SEO services and want an honest baseline before engaging an agency.
• You've been told your SEO is "fine" but you have no data to confirm or challenge that assessment.

This audit is a diagnostic tool, not a treatment plan. It tells you where the problems are and how significant they appear to be. For the implementation steps — the specific fixes — see the companion checklist in this cluster. If the audit reveals gaps you're not equipped to address internally, the final section of this guide outlines when professional support makes practical sense.

Note: This guide provides general educational guidance for PT practice websites. It is not legal or compliance advice. For HIPAA-specific obligations or ADA accommodation requirements, consult a qualified attorney or compliance specialist familiar with healthcare regulations in your state.

Before diving into each diagnostic area, establish a consistent scoring framework so your findings are comparable and actionable.

Rate each item in the audit on a simple three-point scale:

• 0 — Not in place: The element is missing, broken, or producing negative results.
• 1 — Partially in place: The element exists but has meaningful gaps or inconsistencies.
• 2 — Fully in place: The element is complete, consistent, and functioning as intended.

Each of the four audit dimensions contains between five and eight checkpoints. After scoring each section, calculate a percentage: your section score divided by the maximum possible score. Use the ranges below to interpret your results:

• 85–100%: Strong. Minor optimization opportunities may exist, but this area is unlikely to be suppressing your rankings.
• 60–84%: Moderate. Gaps exist and are likely affecting performance. Prioritize fixes here.
• Below 60%: Significant weakness. This area is actively limiting your search visibility and should be addressed before other optimization work.

After completing all four sections, compare scores across dimensions. The lowest-scoring dimension is almost always your highest-use starting point — not because it's easy to fix, but because foundational gaps in one area will limit the returns on work done in other areas.

For example, if your technical health score is below 60%, improving your content or building more citations will produce diminished results until the technical issues are resolved. Fix the foundation first.

Record your scores in a simple spreadsheet as you work through each section. You'll reference this document when deciding whether to pursue fixes in-house or engage outside help.

Technical SEO covers the structural and mechanical aspects of your website — the elements that determine whether Google can find, crawl, index, and render your pages correctly. No amount of content or link-building compensates for a technically broken site.

Checkpoint 1: Crawlability and Indexing

Open Google Search Console and navigate to the Coverage report. Look for pages marked as "Excluded" or "Error." A healthy PT practice site should have the majority of its important pages indexed with no significant crawl errors. If you find that key service pages or location pages are excluded, investigate the cause — it may be a noindex tag left over from a development environment, a blocked robots.txt rule, or a redirect chain.

Checkpoint 2: Page Speed and Core Web Vitals

Run your homepage and your primary service pages through Google PageSpeed Insights. Pay attention to the mobile score specifically, as most patients searching for physical therapy services use mobile devices. Industry benchmarks suggest that healthcare sites with poor Core Web Vitals scores tend to rank behind competitors with comparable content but faster load times. Common culprits for PT sites: uncompressed images from photo galleries, third-party scheduling widget scripts, and poorly optimized video embeds.

Checkpoint 3: Mobile Usability

In Google Search Console, check the Mobile Usability report. Flag any pages with tap targets too close together or text too small to read — these are especially problematic for PT practices, whose patients often include older adults navigating on smaller screens.

Checkpoint 4: HTTPS and Security

Confirm your site runs entirely on HTTPS with no mixed-content warnings. This is a baseline trust signal for any healthcare site. Patients submitting intake forms or appointment requests on a non-secure page is also a HIPAA-adjacent risk that compliance reviewers will flag.

Checkpoint 5: Structured Data

Check whether your site uses LocalBusiness or MedicalBusiness schema markup. Structured data helps Google understand your practice's name, address, hours, and services — and can improve how your listings appear in search results.

Content is where most PT practices have the most room to improve — and the most common source of the disconnect between "we have a website" and "our website generates patients."

Checkpoint 1: Condition and Service Page Coverage

List every condition your practice treats and every service you offer. Now check whether each one has a dedicated page on your website. Many PT sites consolidate everything into a single "Services" page with brief bullet points. This approach means you're competing for dozens of search queries with a single page, rather than giving each condition its own targeted content.

Priority targets typically include: post-surgical rehab, sports injury treatment, back and neck pain, shoulder rehabilitation, vestibular therapy, and pelvic floor PT — depending on your specialties. Each should have its own page with substantive, specific content.

Checkpoint 2: Keyword Alignment

For your top five service pages, check whether the page title, H1 heading, and first paragraph actually contain the phrases patients use to search for that service. Vague headlines like "Our Approach to Care" do not signal topical relevance to Google. Compare your page content against the search terms you find in Google Search Console's Performance report — specifically queries that are generating impressions but few clicks.

Checkpoint 3: Thin or Duplicate Content

Pages under approximately 300 words rarely rank for competitive healthcare searches unless they serve a very specific navigational purpose. Flag any service or condition page with thin content as a priority for expansion. Also check for duplicate content across location pages if you operate multiple clinic sites — identical copy on each location page is a common and fixable problem.

Checkpoint 4: FAQ and Patient Education Content

Does your site answer the questions patients ask before and after scheduling? Content that addresses "what to expect at your first PT appointment" or "how long does physical therapy take" captures early-funnel search intent and builds the kind of topical authority that supports your core service pages.

For most physical therapy practices, local search is the primary acquisition channel. Patients search for PT services near them — and Google's local results (the Map Pack) dominate the first page for these queries. This section diagnoses your practice's visibility in that local ecosystem.

Checkpoint 1: Google Business Profile Completeness

Open your Google Business Profile and evaluate each field: business name (matching your legal practice name exactly), address, phone number, website URL, hours (including holiday hours), primary and secondary categories, services listed, and photos. The primary category should be "Physical Therapist" — not a generic healthcare category. Profiles with complete information and current photos consistently outperform incomplete profiles in the Map Pack, based on patterns we observe across engagements.

Checkpoint 2: NAP Consistency Across Healthcare Directories

Your practice's Name, Address, and Phone number (NAP) should be identical across every directory listing. For PT practices, the high-priority directories include Healthgrades, WebMD, Zocdoc, Yelp, and your state's physical therapy association directory if one exists. Inconsistent NAP data — different suite numbers, abbreviations, or phone numbers — confuses Google's local ranking signals. Run your practice name through a citation audit tool (BrightLocal or Whitespark offer free limited versions) to identify mismatches.

Checkpoint 3: Review Volume and Recency

Check your Google review count and the date of your most recent review. In our experience working with healthcare practices, review recency matters as much as total volume — a practice with 80 reviews but none in the past six months often loses ground to a competitor with 40 reviews that are actively accumulating.

For HIPAA compliance, review your response strategy: never confirm that a reviewer is a patient, never reference treatment details in responses, and avoid language that could be construed as acknowledging a clinical relationship. This is educational context — verify specific obligations with a healthcare compliance attorney.

Checkpoint 4: Location Pages for Multi-Site Practices

If you operate more than one clinic location, each location should have its own dedicated page with unique content — not a duplicate of another location page with the address swapped. Each location page should also be linked from your Google Business Profile for that location.

Compliance gaps on a PT practice website create two distinct risks: regulatory exposure and reduced search visibility. Google's quality evaluator guidelines place healthcare sites under heightened scrutiny for trustworthiness — and elements that raise compliance questions can affect how your site is assessed by both automated systems and human reviewers.

This section provides general educational context only. It is not legal or compliance advice. Consult a qualified healthcare attorney for guidance specific to your practice and state.

HIPAA-Adjacent Website Elements

Audit the following for potential HIPAA risk (as of 2024, verify current guidance with your compliance counsel):

• Online intake forms: Are they submitted over HTTPS? Is the form hosted by a HIPAA-compliant third party with a signed Business Associate Agreement?
• Live chat or chatbot tools: Many standard chat widgets are not HIPAA-compliant for healthcare use. Check your vendor's compliance documentation.
• Patient testimonials: Written testimonials should be accompanied by a signed authorization. Video testimonials carry additional requirements. Generic "before and after" framing without clinical claims is generally lower risk, but verify with counsel.
• Google Analytics and ad tracking pixels: Post-2022 HHS guidance created questions about tracking technologies on healthcare sites. This is an evolving area — confirm your current setup with a compliance specialist.

ADA Web Accessibility

Physical therapy practices serve patients with mobility limitations, chronic pain conditions, and other disabilities — which makes web accessibility both ethically important and legally relevant under the Americans with Disabilities Act. Run your site through the WAVE accessibility evaluation tool (free, web-based). Flag: missing image alt text, insufficient color contrast, inaccessible form labels, and video content without captions.

State Practice Act Advertising Rules

Many state physical therapy licensing boards regulate how PT services may be advertised, including restrictions on promotional language, required disclosures, and rules around claiming specializations. Review your state board's advertising guidelines and compare them against your website copy — particularly on pages that reference specialties, certifications, or outcomes.