check

For the Team: ONE team member fills out

This is general information about your office that only ONE team member on your team needs to fill out.

Communicate Questions include general office questions & social media questions 

Click the button below to start.

Start

Question 1 of 11

Please list ALL employees here (even those not apart of this program) and their title: 

Question 2 of 11

What Software to you use to track patient appointment and schedule? What Payment Processor to you use?

Question 3 of 11

Do you have an Open Adjustment Area or are there Private adjusting rooms at your office?

Question 4 of 11

How long is your average patient visit (how long does their adjustment take)?

Question 5 of 11

Average number of Patient visits a day?

Question 6 of 11

What is your New Patient Procedure, Explain if you have a Day 1 and Day 2, What your normal new patient price is, if they get adjusted Day 1?

Question 7 of 11

Do you take X-rays at your office for every New patient? If not, do you refer out for X-rays or do not use them in general?

Question 8 of 11

Do you invite the Spouse or a Support person to the Report of Findings if you have one?

Question 9 of 11

Are you in or out of network with Insurance?

A

In Network

B

Out of Network & Patient Submits

C

Out of Network & We Submit for Patient

Question 10 of 11

Do you take Care Credit or have finance options? If you take care credit, what finance options do you offer (6,12,18 months)? Do you still offer a discount with Care Credit?

Question 11 of 11

Please list EVERY source of income at your office. For example do you offer supplements or cold laser or decompression etc?

Confirm and Submit