Our dental client's profits increased 27% in 2008

Maybe we can help make 2009 your best year ever

There are 25 numbered questions. Answer each question one of three ways by selecting one of the boxes next to each question:

+	(Plus) means VITAL, top priority for immediate improvement
M	(Middle) means DESIRABLE , could use some improvement
-	(Minus) means UNWANTED, uninterested or needs no improvement.

Answers should be based on present conditions and circumstances.

IN MY PRACTICE I WOULD LIKE TO:

1. Standardize scheduling protocols so we don’t fall behind and I’m not frequently interrupted.

+	M	-

2. Be more effective at presenting, and getting compliance to major treatment plans.

+	M	-

3. Get financial arrangements effectively handled so Tx plans don’t “fall through the cracks”.

+	M	-

4. Control my time better so I’m more productive.

+	M	-

5. Create or implement and maintain an effective soft tissue management program.

+	M	-

6. Cut down on missed or rescheduled appointments and/or improve our recall system.

+	M	-

7. Improve our effectiveness at collecting cash and co-pays from patients.

+	M	-

8.Resolve reduced fee for service issues or effectively eliminate capitation in my practice.

+	M	-

9. Have standard policies and protocols that my staff are aware of and can follow.

+	M	-

10. Handle it so I don’t have to continually do staff member’s jobs or make decisions for them.

+	M	-

11. Motivate my staff into having the same purpose and enthusiasm I have.

+	M	-

12. Know how to hire loyal and effective staff, the first time.

+	M	-

13. Be able to increase staff wages, benefits and/or create an effective bonus system for them.

+	M	-

14. Create more staff stability, and less staff turn over.

+	M	-

15. Improve my relationship with staff.

+	M	-

16. Know how to be more effective as a leader.

+	M	-

17. Effectively bring an associate on board without creating problems in the practice.

+	M	-

18. Prepare for the transition of a Buy-In or Buy-Out of my practice.

+	M	-

19. Be more effective at marketing so new patients routinely come in.

+	M	-

20. Know how to train staff to ask for referrals without feeling “awkward”.

+	M	-

21. Prepare for a secure retirement to take place within the next 5 years.

+	M	-

22. Know how to increase my personal net income.

+	M	-

23. Be able to avoid slumps in income.

+	M	-

24. Be able to set aside more money for savings and retirement.

+	M	-

25. Have more free time for personal activities.

+	M	-

This questionnaire will be used in conjunction with a FREE NO OBLIGATION practice management consultation.

Your personal information will only be used for your Free Practice Management Consultation and will be kept strictly confidential.

First Name:
Last Name:
Are you the owner or spouse?	Yes No
State (US):
Email
Phone:
Alternate Phone:
Best day and time to contact you to schedule your Free Practice Management Consultation:

Toll Free 800-595-2380

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