What city & state/province do you practice in?
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How many new patients are you currently seeing every month (doesn't have to be exact)?
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What's your goal for case starts monthly?
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How long have you been practicing for?
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1 Year or Less
1-4 Years
Over 5 Years
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How much do you allocate in marketing for new patients?
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0
$1,000- $2,500/mo.
$2,500- $4,500/mo.
$4,500- $10,000/mo.
$10,000+/mo.
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Which best describes you?
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I'm just curious
I'm ready to move forward
I have a problem and need it fixed now
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Do you have a front office team member who can do daily follow up with Internet leads?
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Yes, I do.
No, don't.
Don't know yet.
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Your website
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Full Name
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Mobile Phone
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