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Step 1 of 6

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Are you achieving the results you want from your practice?*
- Yes I have the time and money I want
- Yes I am achieving my financial goals but have no time
- I’m not hitting my financial goals and I don’t have enough time

How long have you owned your practice?
- 1-3 yrs
- 3-5 yrs
- 5-10yrs
- 10+
What stage of growth is your practice at?
- Survival (just getting by)
- Stability (Going OK but Stuck in neutral)
- Successful (Looking to scale)

About your self, what's your name?*
First Last
If you are struggling to hit your goals, tell me about your challenges…*

Do you have a website / funnel?*
- Yes
- No
Website
Approximately, What is the size of your active patient base?
- 0 - 250
- 250 - 500
- 500 - 1,000
- 1,000 - 2,500
- 2,500 - 5,000

In your opinion, What do you think will need to change to achieve your goals?*
- A Better team
- Better Systems
- More Patients
- More returning patients

What is your email address? I'd like to send you some information*
What's your best phone number?*
What kind of situation are you in right now?
- I want a DIY Solution (I would rather learn it and me/my team do it internally)
- I want a Done With Me Solution (Do the work myself with specific coaching/guidance)
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