Well..I can tell you how we at Sudden Impact Web Design do it. We're a husband and wife, family-owned and operated digital marketing agency. We don't have a fortune to put into huge marketing efforts. But we do, however, have me (blush, blush), and I used to be a reporter and freelancer and learned to hustle at a young age.

One of the things we did when we first started was go online and print up a huge stack of postcards, coupons, business cards, and drive around to local area industrial parks, office parks, neighborhoods with shops in them; and simply go door to door introducing ourselves and giving out cards. No hard-sell or pressure, just casual, polite introductions and a card. Did most of the cards end up in the trash? Probably. But the cards that received calls back (to us) got the best service and best returns on investment they ever dreamt of. Those efforts got us referrals upon referrals. And when that well runs dry every once in a while, we can simply "wash and repeat."

Now, yes, a professional online presence that employs smart SEO, Google Analytics, Google Adwords, Facebook ads, regular blogging, active social media...all of that will get you more leads and referrals as well but nothing beats returns on time like physically going out and kissing babies and shaking hands, except giving presentations before large professional organizations.

Hope that helps. If you'd like more, just give me a ring. Good luck.