Do you know of a good SEO Audit lead gen tool I can add to me site?

Looking for an SEO audit widget that I can embed on my site as a lead gen tool.

Need something that works like this: Users comes to my site > inputs email and URL > SEO report is automatically generated and delivered via email > I collect the email and URL as lead data.

Hopefully it has these 3 features:

1. Affordable - preferably just a one time fee, or low per lead cost
2. Brandable - using my own domain and logo etc
3. Have a modern design - the report should not look like it's from the 90's

Any ideas?

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