Blatchford Solutions Custom Coaching Program for the Dental Profession

For more information on how Blatchford can help you rediscover your own dreams and desires by increasing your revenue and helping you to control your overhead, please fill out the practice analysis below. We respect your privacy and all information will be kept confidential.

Blatchford Practice Analysis
*Denotes Required Fields
Your Practice Information
Location Age	years
Number of Years in Location	years
Full Name*
Email*
Address

Alumna/Alumnus of which Dental School?
What are you hoping to accomplish with this analysis?
Increased net for retirement
Increased enjoyment of dentistry
Profitability for life style
Slower pace with same or better net
Funding education funds, weddings, family events
More time off to enjoy life's journey
Other
Other Information
Days per year worked?
Annual Gross	$
Annual net, including debt reduction, Dr. salary, pension	$
Number of Staff
Number of Associates
Number of Partners
New Patients per Month
Overhead Percentage of Staff	%
Days of Hygiene
Total A/R
Overhead Percentage of Lab	%
Describe your Current Marketing
Describe current Consultants and Results
Are you considering a consultant now? Why?
Are you considering a practice purchase, move or sale?
What are your retirement plans?
What is your current funding to accomplish this plan?
Satisfaction
On a scale of 1-10 evaluate your:	Physical facility
	Satisfaction with dentistry
Explain:
Describe Your Dream Practice
Location
Gross and Net
Hygiene
Mix of Treatment
Scheduling
Annual Days at Work
Retirement Savings at what Age?



	October 07, 2008 Teleconference — YOUR END GAME October 14, 2008 Teleconference — Playing Your A Game with Dr. Crisp - Small Town Dentist, Doing Great October 22, 2008 Speaking Event — Smile Vision Teleconference

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	Blatchford FILES CDs
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	Playing Your ‘A’ Game
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	Playing Your ‘A’ Game — Audio 2-Disc Set
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	BUY!