About You Please fill out the questionnaire below and we will contact you to set up a video conference call to discuss how we can help and make sure we answer any questions you have.Company Name(Required) Your Name(Required) First Last Email(Required) Phone(Required)What are the 2 most important results you are looking for?(Required) Your current number of new patients per month?(Required)What is your new patient per month goal(Required)What is your current monthly spend on marketing?(Required)What is your average monthly collections?(Required)What is your monthly collection goals?(Required)Does a doctor or treatment coordinator do case presentations?(Required) Doctor Treatment Coordinator Other Do you have (choose one)(Required) Sleep Practice Dental Practice Combination What time of day is best for us to contact you to discuss your needs or set up a zoom meeting?(Required) List your current websites(Required)Does your office currently offer IV sedation?(Required) Yes No Do you think your office would benefit from training on case acceptance and treatment planning?(Required) Yes No What services are you trying to grow?(Required) Full arch implant cases Aligner cases Functional occlusion/rehabs Periodontal Sleep apnea IV sedation cases Check all that apply that describes your current marketing efforts(Required) Google ads Facebook/social media ads Direct mail Website/seo Val pack Informational seminars Referrals from other dentist TV ads Radio ads Billboards Other
