Step 2 – Contact

Step 3 – Practice Info

Step 4¬†–¬†Payment

3S Application

Client Application
How did you hear about us?
What are your current practice statistics?
Avg. Patient Visits/Week
Total Active Patients
Avg. New Patients/Month
What percentage of your practice is based on cash? Insurance?
Cash?
Insurance?
Which practice management, coaching or consulting company have you been a member or are currently a member of?
Name?
How long?
Please describe how you recommend care to your patients? For example, do you prescribe detailed care plans or recommend your care visit by visit. Please explain your processes thoroughly.
Do you train yourself and your staff regularly on practice procedures? For example, training on specifics for patient communication. If so, what types of things do you train on and how often?
What are your goals for practice? What would you like your MINIMAL annual income to be? How many active patients would you like to be seeing every week? What does your dream practice look like?
Sending

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