APPLICATION FOR
THE PRACTICE PRO MASTERMIND

Name

First Name

Last Name

Practice Name

Website

http://

Phone

(###)

###

####

Years In Business

Current Revenue

$15 000 - $39 000 PA

$40 000 - $80 000 PA

$80 000 + PA

Prefer not to say

Practitioner Level

Principal

Partner

Associate Chiro

Describe your current client base.

Who do you see predominantly in your practice? If this who you want to be seeing?

What percentage of your current client base is children?

Please provide an estimate for the following categories: newborns, infants, toddlers, young children, tweens, teens, young adults?

What are you hoping to achieve through this Mastermind?

Let me know what areas of your business you are struggling with and where you feel you need the most support. This could be in technical knowledge or practice management.

Describe a week in your practice.

Please describe an average week in your practice: Work days and hours, complexity of cases, administration, further education, practice building tasks, and any other pertinent information to how you run your business.

APPLICATION FORTHE PRACTICE PRO MASTERMIND

APPLICATION FOR
THE PRACTICE PRO MASTERMIND