What do you see as the # 1 challenge for your dental practice? Please check the appropriate box. If there are multiple issues, you may check more than one box.

    I see too many broken appointments on the schedule

    I see gaps in the schedule from lack of new patients.
            My current new patient flow is per month.

    Patients are not accepting comprehensive care and are postponing treatment

    Practice overheads are high

    Staff Issues

    I want to increase office production and collections

    I am not sure, but my practice is not doing as well as I'd like it to.

 
Other Comments/Notes:

Person filling in this form:  Indicate Your Title Doctor Spouse Office Manager Other *


Owner Doctor's Name: *


Location of Practice:
City: *
State: *
ZIp Code: *

Number of years in practice:

E-mail address: *
Doctor's Office Phone: *
Doctor's Cell Phone: *

You will receive a call from Visionary Management within 2 business days to discuss your situation. Our first choice is to call the doctor’s cell number, as we do not wish to discuss confidential matters with staff members.