PREFERRED PROVIDERS

* 1. Thank you for taking a moment to fill out our member survey. This survey is designed to help you discover ways to improve your practice, and for us to gather information about what members are experiencing in private practice to better serve them. It also allows us to help connect you with professionals who can help you reach a new level of success if you so choose. Please give each question some thought and be truly honest in your response. As always with Dentistry Unchained, your answers and personal information will be kept in the strictest of confidence. To be clear, we will not share this information with ANYONE unless you ask us to share it with professionals that can help you reach a new level of success in your practice.

* 2. Which of the following market factors are currently affecting your practice success and profitability? (mark all that apply)

* 3. What are your biggest frustrations as an independent practice owner? (mark all that apply)

* 4. Which of the following best describes your current practice?

* 5. Which of the following best describes your ideal practice?

* 6. Which of the following costs have the greatest affect on your practice's profitability?

* 7. What are your greatest STRENGTHS as an independent dentist? (check all that apply)

* 8. What are your greatest WEAKNESSES as an independent dentist? (check all that apply)

* 9. Which of the following do you feel would have the greatest positive impact on your practice?

* 10. What would you do most likely do with the additional $25,000 you can save annually as a Dentistry Unchained Member?

* 11. Would you like us to connect you with dental industry professionals who are experts in helping independent practices in the areas you have indicated you would like to improve?

Thank you for taking the Dentistry Unchained Member Survey. Unless you indicated otherwise, your answers will not be shared with any outside entity. We will use this information to help better serve you and our members. We value you as a member, and hope that you experience new levels of profitability and fulfillment in your practice as a result of your membership with Dentistry Unchained. As always, we appreciate you speading the word to your colleagues about us. Together, independent dentistry can break free and thrive!

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