What does a fractional CMO do in the first 90 days?

The first 30 days are for access, listening and measurement. The fractional CMO gets into every account, interviews leaders and key staff, audits tracking and compliance, and sets a baseline of current results. Big changes wait. Changing campaigns before understanding them often destroys the data needed to judge what worked.

Typical first-month work

• Access: ad accounts, analytics, CRM, website, Google Business Profiles, email tools and agency reports.
• Interviews: founders or owners, sales, clinical leads, operations and any agencies.
• Funnel audit: where leads come from, how fast they are answered and how many become customers or patients.
• Compliance check: ad tags on sensitive pages, consent for texts and email, review practices, and whether vendors that touch patient data have signed BAAs.
• Baseline: the current numbers, written down, so later progress can be judged fairly.

On tracking, the HHS guidance on online tracking technologies is a useful reference. Confirm your obligations with counsel.

The third month is about execution and rhythm. The plan runs, agencies work to their briefs, and the fractional CMO sets the weekly and monthly review habits the company will keep. By the end of it, leadership should receive a board-ready report that compares results with the baseline from month one.

• Weekly check-ins on leads, conversion and spend.
• A monthly review of each channel against its goal.
• Early tests of new messages or channels, small and time-boxed.
• A first report to leadership or the board, honest about what has and has not moved.
• Next-quarter priorities, adjusted to what the first months showed.

Results in the third month are early signals, not final verdicts. SEO and partnerships often need longer. Paid search and follow-up fixes may show sooner.

What the first board report should cover

A useful first report is short. It restates the baseline, lists the goals agreed in the second month, and shows progress against each one. It names what was fixed and what still needs work. It explains any budget moves and why they were made. And it sets out the priorities for the next quarter, with an owner for each. Leadership should be able to read it in a few minutes and ask sharper questions as a result.

Prepare access, documents and people before the engagement starts. First-month delays usually come from waiting for logins, missing data or leaders who are too busy for interviews. Sending the access list, contracts and recent numbers in the first week, and booking interview slots in advance, lets the audit start on day one instead of week three.

1. Access list: admin or analyst access to ad accounts, analytics, CRM, website and email tools.
2. Contracts: current agency agreements, BAAs with vendors and a BAA with the fractional CMO's firm if patient data may be involved.
3. Numbers: recent revenue, customer or patient counts by source, and current marketing spend by channel.
4. Prior work: past plans, brand guidelines, research and board decks.
5. Calendar time: interview slots with founders, sales, clinical and operations leads in the first two weeks.
6. Decision rights: what the fractional CMO can approve alone and what needs leadership sign-off.

Warning signs include no written baseline after the first month, a plan with goals nobody owns, sweeping campaign changes before the audit, and reports that show activity instead of results. Any one of these means the engagement needs a direct conversation, not more time.

• Recommendations that arrive before the fractional CMO has seen your data.
• A plan that lists many channels without saying what will stop.
• Agencies left without written briefs or goals.
• Reports full of impressions and clicks but silent on leads, customers and cost.
• Compliance gaps noted in the audit but not fixed or assigned.

Good engagements feel calm and specific. Leadership knows what is being done this month, why, and how it will be judged.