Is your schedule unpredictable?
Yes Maybe No
Are patients with incomplete treatment contacted regularly?
Yes Maybe No
Are collections at least 98%?
Yes Maybe No
In general do your staff know how to do their jobs at a high level of efficiency?
Yes Maybe No
Do too many confirmed patients still break their appointments?
Yes Maybe No
Are you on track to meet your personal financial goals?
Yes Maybe No
In the past two years has production plateaued or declined?
Yes Maybe No
Are there too many staff conflicts?
Yes Maybe No
Have you lost several staff recently?
Yes Maybe No
Do you have sufficient time to train your staff?
Yes Maybe No
Do you have an effective dental marketing program?
Yes Maybe No
Do you have written training manuals for your staff?
Yes Maybe No
Is your percent of payroll over 27%?
Yes Maybe No
Is staff morale high?
Yes Maybe No
Does the relationship with your staff need improvement?
Yes Maybe No
Are you an effective leader?
Yes Maybe No
Are you too "nice a guy or gal" with your staff?
Yes Maybe No
Are you able to schedule new patients within a week?
Yes Maybe No
Do you feel you need more new patients?
Yes Maybe No
Do you and your staff feel “awkward” asking for referrals?
Yes Maybe No
Is your retirement secure?
Yes Maybe No
Do you find yourself thinking too much about the office when you're at home?
Yes Maybe No
Do you have slumps in income?
Yes Maybe No
Are you in control of your practice?
Yes Maybe No
Do you enjoy going to work?
Yes Maybe No

Contact Info

This questionnaire will be used in conjunction with your free, no obligation, phone consultation. Your personal information will only be used for your consultation and will be kept strictly confidential.
Name
First Last
Position at your practice
Owner Spouse Manager
Email

Your email address is kept strictly confidential and is NEVER sold or shared with any other organizations.

Cell number
###- ###- ####

Due to large number of responses we do not leave messages with the front desk. We only contact you by cell, office back line or home number to schedule.

Office back line or home
###- ###- ####
State
Best day of the week to contact you
Best time to contact you.
8am - 12pm 12pm - 5pm 5pm - 8pm

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