What city & state/province do you practice in?
How many new patients are you currently seeing every month (doesn't have to be exact)?
What's your goal for case starts monthly?
How long have you been practicing for?
Please Select...1 year or less1-3 yearsOver 5 years
How much do you allocate in marketing for new patients?
Please Select...0$1,000 - $2,500/mo.$2,500 - $4,500/mo.$4,500 - $10,000/mo.$10,000+/mo.
Which best describes you?
Please Select...I'm just curiousI'm ready to move forward if the opportunity is rightI have a problem and need it fixed now
Do you have a front office team member who can do daily follow up with Internet leads?
Please Select...Yes, I do.No, I don't.Don't know yet.
Your full name
Your phone number
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