Strategy Session Form
First Name
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Last Name
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Personal Phone Number
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Email
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Practice Name
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Your Position
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Practice Website
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How Did You Hear About Dr. Nick/LVRG Media and What Triggered You To Schedule This Strategy Session
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What is your average number of patient VISITS per WEEK?
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What is your average number of NEW PATIENTS per MONTH?
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NEW - How Much In Collections Have You Averaged Per Month In The Past Six Months?
$0-10K
$10-20K
$20-30K
$30-50K
$50-75K
$75-100K
$100K+
What top three places do your new patients come from?
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In a perfect world, what would you like to accomplish in the next 12 months when it comes to your online marketing?
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Why is now the time to do something about your online marketing?
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SUBMIT & SELECT A TIME