Please include First and Last Name
What is your primary goal?
What procedures are most important to the success of your practice. Please list in order of importance.
We will optimize for procedures, but if there are other terms that are important to your practices (i.e. top dentist, blue cross dentist, dental financing, etc.)
Here is your chance to tell us what is most important to you.
For example - Families, emergency patients, retired individuals, etc.
Please specify nearby cities or regions from which you expect to receive patients. Please try to keep to 5-10 locations. Go ahead and list cities, counties or communities that are appropriate for your area, in order of importance to you.
If you would like to continue using the same Analytics account you currently have, please provide your current Analytics Tracking ID (i.e. UA-12345678-1)
For Example: Experience, Staff, Service, Advanced Technology, Comfort, Top Procedures, Financing, Flexible Hours
For example, do you place dental implants in your office? Offer sedation services? Use certain advanced technology?
If Yes, What is that name?
Please include old practice names, addresses and phone numbers.
Please include their first and last name.
We look closely at website visitor traffic patterns, and need to filter any traffic which comes from you or your office staff. Please go to www.myip.dk from EACH computer (although the numbers may be the same) in your office and your personal computer – List the numbers:
Please include anything you would like to discuss during your consultation or any special concerns you have.