Name * First Name Last Name Email * School * Areas of concern * Check all that apply New Patients Retention Profit Workload Cash Collections Lanes of Service Hiring Staff In the last 90 days, has your practice gone: * Up Down Even Average visits per week * New patients per week * Patient Visit Average * % Insurance vs. Cash * Average collections per week * Average collections per month * Number of doctors * Number of staff * Number of treatment rooms * Approximately how much time do you spend with each patient * Techniques used * Therapies offered * Other services * Marketing efforts * Last seminar attended Notes/Comments Thank you!
