Practice Analysis Survey
First Name
Last Name
Email
*
Cell Phone
*
Your Position
Organization/Office Name
Address
City
State
Zip/Postal code
Website
Office Main Phone Number
Office Hours
How many new patients do you get per month (on average)?
What is the average production value of a new patient? For example on their first year in your practice how much production does a new patient bring on average?
What is the average monthly production and collections for your office?
How many cases do you complete per month? And how many have you completed in total?
What marketing or advertising are you doing currently, if any? Please provided specifics if you can, like: mailers, website, PPC ads, etc., and how much your monthly marketing expenses are.
How much are you spending on your marketing overall each month?
Do you know the breakdown of how many new patients are coming from which referral source each month? And do you know which sources are bringing in the most new patients?
Do you currently have any type of call tracking system in place? If so, please explain how you use it, and what numbers you are tracking (website, mailer, etc.)?
Who currently handles the marketing functions in your office (internal and external marketing)? Please explain how this works.
How many GOOGLE reviews do you have and what is your star rating? Do you have a system of generating more?
Are you active on social media (Facebook, Instagram, etc.)?
What is your current practice management software?
How many total patients do you have (active & inactive)?
Do you collect the cell phone and email addresses of your patients? If so, how many do you have?
Do you use an online scheduler to book appointments. i.e., ZocDoc, LocalMed, DemandForce?
What month and year did you open this practice and how long have you been practicing at this location?
What is the medium and long term strategy for your practice? Do you have a plan to gain financial freedom?
What is your biggest obstacle right now to achieving your goal?
Is there anything else you would like to let us know?
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