Online Practice Assessment

First Name

Last Name

Email Address

Phone

City

State or Province

How long have you been practicing dentistry?

How long have you been at your current location?

How many more years do you plan to practice?

How many team members do you have?
(Associates, Hygienists, Dental Assistants, Office Manager, Admin)

How many active patients do you currently have in your practice?

On average, how many new patients do you get per month?

Have you seen a change in Case Acceptance recently? Has it increased or decreased?

What percentage of your day are you spending on daily operations versus dentistry?

On a scale of 1 to 10 (1 being low, 10 being high) how would you rate your level of stress in relation to your team and daily operations?

If there were 2 things you could change about your practice, what would they be?

What part of having a dental practice do you like the best?

What part of having a dental practice do you like the least?

When is the best day and/or time for us to reach you to discuss your responses?

Thank you for completing the Online Practice Assessment.
Your completed questionnaire will be forwarded to one of our Client Relations team members, who will contact you within 24 hours to review your responses.