Page title

First Name

Last Name

Cellphone Number

What is your office Website URL?

In order for your Coach to help you achieve the best outcome from your Breakthrough Call, approximations are fine... there is no need to run reports.

Roughly what was your last 12 months' production? (please use commas)

Approximate production adjustments last 12 months due to PPO contracts?

In Hygiene, roughly how many TOTAL CHAIR HOURS are bookable per week regardless of whether they are filled or open?

How long have you been thinking about reducing your dependence on PPOs?

How many PPOs are you in-network?

% of your patients are in-network with 1 of your plans?

If in-network with PPOs, use your best guess for your average allowable fee

Build-up and Crown

1 Quadrant of Scaling & Root Planing

Adult Recall Incl. Prophy, Periodic Exam, Bitewings

Thank you, doctor, that was super helpful.
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