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* 1. What's your full name?

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* 2. What is a the best phone number to reach you at?

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* 3. What is the best email address to reach you at?

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* 4. What are you trying to achieve and what do you need help with the most right now?

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* 5. What is your ultimate goal that you wish to achieve in our coaching together?

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* 6. What are you doing now to attract, retain and reactivate patients? Please list out all marketing activities that you currently participate in.

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* 7. What’s your biggest struggle in your practice?

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* 8. How many patients do you see per week?

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* 9. What is your ultimate goal in patient visits per week?

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* 10. How many new patients do you get per month?

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* 11. What is your ultimate goal in referrals per month?

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* 12. What is your average number of visits per patient?

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* 13. What is your current annual income?

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