Contact

Pam Gorrell

Phone: 650.968.2809
Fax: 650.968.6209
Email:

Your thoughts on the following information will be beneficial to our meeting. You can either submit this form to me before we meet, or just bring it with you to refresh your thoughts. Download printable PDF version.

1. What would you like to know about me and my experience in
consulting with dentists?

2. How long have you owned this practice?
3. Average monthly production (last 6 months)
4. Average monthly collections (last 6 months)
5. Current total Accounts Receivable (+ 90 days)
6. What amount do you need to collect monthly in order to cover all of your practice expenses and your compensation?
7. What % of your practice fee is for service?
8. How many new patients do you average monthly? (last 6 months)
9. How many patients are in your base? (i.e. seen in the practice over the last 18 months)
10. How many hygiene days per week do you currently schedule?
11. Do you have a current and legal employee policy manual?
12. How many team members do you employ?

13. What are the most important issues that you would like to address regarding
team members?

14. What are some concerns you have regarding practice systems, i.e., scheduling, recall, financial systems, insurance, etc.?

15. Please list some leadership characteristics you feel work well for you.

16. Please list some leadership characteristics that you feel need improvement.

17. Please feel free to jot down additional concerns you want to address.

Verification Code (case sensitive):

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