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1. Is your practice running as efficiently
and as profitably you would like ? 		Yes    No
Comments:  
2. What is your most challenging practice management problem ?
3. What others areas do you have concerns about at this time?
Keeping collections at 97-98 % Yes   No
Comments:  
Attracting enough new patients Yes   No
Comments:  
Reducing insurance hassle? Yes   No
Comments:  
Scheduling Productively? Yes   No
Comments:  
Accounts receivable? Yes   No
Comments:  
Staff management Yes   No
Comments:  
Treatment acceptance Yes   No
Comments:  
Hygiene department profitability Yes   No
Comments:  
Recall Yes   No
Comments:  
Overhead - Your take home Yes   No
Comments:  
4. Would you be interested in a Complimentary -
1 hour phone call - with one of our consultants? 		Yes   No
5. Would you be interested in a call regarding
a By-the-Numbers Practice Analysis 		Yes   No
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