Help Our Coaches Understand Your Practice

This information allows you to get the most out of your strategy session with one of our expert coaches. Expect the call to take 30-45 minutes. During that time, we’ll review your goals and the steps for a Total Freedom practice. This is the final step…

Practice Name: *

First Name: *

Last Name: *

Cell Phone *

Spouse’s Name *

Email *

City / Town: *

State / Region / Province *

Country *

How did you hear about us? *

Select a Strategic Partner

Who helps make or influence decisions in your business? *

What type of Practitioner are you? *

Which characteristic best describes you? *

SWOT Personal Life

Strengths: What are your personal strengths? *

Weaknesses: What area’s do you feel you’re weakest in? *

Opportunities: What personal opportunities do you want to explore? *

Opportunities: What personal threats are holding you back or do you feel could be an issue? *

SWOT Business Life

Strengths: What are your business strengths? *

Weaknesses: What area’s do you feel you’re weakest in? *

Opportunities: What business opportunities do you want to explore? *

Opportunities: What personal threats are holding you back or do you feel could be an issue? *

Website *

Office Sq. Ft. *

# of Doctors *

# of Staff *

What is your role in the practice? *

Do you believe you are a quickstart or a follow through? *

Monetary Bonuses for Employees? *

Do you feel like you own a business or a job? *

What is the area that you feel you have the biggest need to improve?*

How well do you think your staff is trained? *

What type of practice would you like to evolve into? *

Where do you want the business to be in the next 3 years? *

Children? *

Are you the main bread winner in your family? *

Do You Enjoy the Freedom You Want? *

How many hours per week are you working? *

If your business were running on autopilot, what would you do with your spare time and money? *

Monthly Marketing Budget *

Marketing Types *
Ctrl+click to select all that apply

Services Offered *

Revenue Streams *

Avg Revenue Per Month for Current Year *

Last Month’s Revenue *

% of Collections Insurance *

How much money do you have in reserves? *

Average # of New Prospects (actual new consults) Per Month *

Actual # of New Prospects (actual consults) Last Month *

Average # of New Sign-Ups (new patients or members) Per Month *

Actual # of New Sign-Ups (new patients) Last Month *

Avg. Revenue Per Patient *

How much is your monthly overhead including salaries and taxes? *

Are you putting enough money away per month currently to be able to retire? *

How much would you like to put away per month toward retirement? *

Help Our Coaches Understand Your Practice

Can a single hour give you more business knowledge than all your years of medical training?

You bet it can.