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DELIVERING PERFORMANCE TO YOUR PRACTICE

Free Practice Analysis

Receive a free confidential analysis and see for yourself

Free Sterling Client Retention Analysis

Do you have an gold mine in your practice?

Name:
Title:
Specialty:	# of Staff:
E-mail:
Address:
City:	State: Zip:
Office Phone:
Home Phone:	(optional)
How did you hear about us?

+	(Plus) means I AGREE, YES or MOSTLY YES
M	(Middle) means UNCERTAIN, MAYBE, NEITHER YES nor NO
-	(Minus) means I DISAGREE, NO or MOSTLY NO

Little competition exists in my area.

+	M	–

The on-going needs of our patients are well-defined and used for reactivating patients.

+	M	–

Our promotional materials effectively produce repeat business.

+	M	–

We do not have a regular communication going out to our regular patients.

+	M	–

We do special promotions which are available only to our existing patients.

+	M	–

Our average treatment per patient is increasing.

+	M	–

We are losing business because of inadequate follow-up of existing patients.

+	M	–

We have a complete data base of past and present patients.

+	M	–

We have a very loyal and expanding patient base.

+	M	–

10.

50% or more of our gross comes from a very small percentage of our patients.

+	M	–

Once we have received your answers, a service consultant will contact you within 24-48 hours, Mon.-Fri., with your test results.