Thank you for your interest in having our Founder and CEO as your personal practice mentor and coach. This package requires a minimum one-year commitment with approval and acceptance after an initial video consultation personally with Mike Massotto. Please complete and submit the contact form and practice questionnaire below, and Mr. Massotto will call you shortly to set up your consultation.

Select the items that you want to improve. Then rate the importance and urgency of the checked item on a scale of 1 – 5, (1 being the most important/urgent and 5 being the least)

Discovery Questionaire

Your Name

Cell Phone

Email Address

Website URL

Collecting what is produced?

Reducing Stress?

Increasing doctor's production?

Scheduling for greater profitability and sanity?

Transforming staff into team?

Increasing new patients (marketing)?

Improving case presentation and treatment acceptance?

More profitable hygiene department?

Clarifying practice and personal goals

Hiring, training and keeping good staff?

Want more time for myself to enjoy life?

Funding my children’s education?

Getting financial arrangements with patients under control?

Funding Retirement?

Enhancing Physical Environment?

Reducing numbers of days worked each week/year?

Improving my business decision making ability?

Getting greater control of time?

Seeing fewer patients and doing higher quality treatment?

Reducing dependence on insurance?

Increasing recare system effectiveness?

Getting control over cancelled and broken appointments?

Lowering overhead costs?

Creating an exit/transition strategy?

Achieving economic freedom?

Improving leadership skills?

Putting all considerations such as time and money aside, on a scale of 1 – 10 (10 being the highest), how committed are you to resolving these issues?

What is your current work schedule for a week? (Please put down your schedule, Monday-Sunday)

How many staff members in your practice?

How many Administrative?

How many Assistants?

How many Associates?

How many Hygienists?

How many Specialists?

Are you participating in any insurance plans? Are you participating in any insurance plans? Yes No

What is your average new patient number per month?

Where do they generally come from?

Total Collections for last year $

Total Collections for this year $

Collection Goal for next year $

9 + 9 =