Practice Analysis Form

To schedule your 1-hour practice development meeting this form must be completed in full and as accurately as you can. Our expert assessments will be based on your answers and what we find on your existing website. It may take 10 to 15 minutes to complete but we promise it will be worth your time.

Doctors Name*
First Last
Doctor's Cell*
Your information will not be shared with others
Office Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website address (i.e. www.thekingofallonX.com)*
When was your website built?*
How is your practice currently performing?*
Please select one
If you answered that you were up or down? What %, + or - are you up or down?*
What is your growth goal for the next 12 months?
What is the Gross Revenue of the practice?*
Select One
What is your case acceptance rate? (Looking for case acceptance on your All-on-X cases or implant cases. 10 Patients schedule and come in and 3 move forward you have a 30% case acceptance rate.*
What is your practice management software, i.e. Dentrix, Eaglesoft, etc..*
What specific procedures do you want to do more of?*
Please prioritize the procedures that you want to increase
Do you utilize a guided solution for your full arch cases?*
Would you be interested in an Interim prosthesis that is a one piece surgical guide? (i.e. JUST 4 STEPS, 2 APPOINTMENTS AND 1 PROSTHETIC DEVICE FOR YOUR FULL ARCH SURGERY WITH IMMEDIATE LOADING IN ONE DIGITAL WORKFLOW)*
List the three greatest obstacles you would like to overcome? (i.e. my team, case acceptance, marketing my practice, etc).*
Do you track and record your practice's incoming calls?*
How many total Google/yelp reviews do you have?*
Do you have an incentive program for your team?*
How do you pay your team?*
Have you provided communication or telephone training to your team?*
What is the least and most effective marketing campaigns you’ve had?*
Are you open to doing television advertising?*
Do you track where patients come from i.e. television, web, etc*
Are you happy with your current website?*
Is your website mobile ready?*
Do you have video testimonials on your website?*
Do you have a Google+ or Google Business page?*
Do you have someone doing your search engine optimization?*
Are you happy with the results of your (SEO) Search Engine Optimization?*
Would you like to improve your website conversion rates?*
Do you know how many website visitors you have each month?*
Do you know what your website conversion rate is?*

Click for Free One-Hour Consultation ›

Practice Analysis Form

Everything dentists need to capture and convert new patients.

15730 North 83rd Way
Scottsdale, AZ 85260
United States

Tel.: Call 1-480-275-7144
Toll Free: Call 1-855-282-3368

Services

Hybrid Product Offering

ABOUT US

Click for Free One-Hour Consultation ›

Practice Analysis Form

Everything dentists need to capture and convert new patients.

15730 North 83rd WayScottsdale, AZ 85260United StatesTel.: Call 1-480-275-7144Toll Free: Call 1-855-282-3368

Services

Hybrid Product Offering

ABOUT US

15730 North 83rd Way
Scottsdale, AZ 85260
United States

Tel.: Call 1-480-275-7144
Toll Free: Call 1-855-282-3368