Just What The Doctor Ordered

As a service to your practice, for a limited time, Opus Marketing Systems™ offers you a free medical practice check-up from the neck up. . Simply fill out this questionnaire and submit. We will contact you or your designee with an analysis of your practice along with concrete suggestions that will help lead you to Practice Prosperity™.

Medical Practice Questionnaire

1. Name: First: Middle Iinitial: Last: 2. Address: Address 1 Address 2 Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming City State Zip 3. Phone Number 4. Cell Number 5. Best time to call: Time AM PM 6. Number of years in practice:Years  ¦  Number years in a cosmetic practice:Years 7. Do you carry medical malpractice insurance? Yes  No 8. Legal structure of practice: ("C" corp., "S" corp., LLC, PA, etc.) 9. Contact Person: First: Middle Iinitial: Last: 10. Are you satisfied with the way that you have financially structured both yourself and your practice in order       protect your assets and legally reduce your taxes? Yes  No 11. Do you have a source for medical practice/medical equipment financing to help grow your business?       Yes  No 12. Web site address: www.. 13. Are you happy with your web site? Yes  No 14. Do you offer skin care? Yes  No        If yes what brand to you offer?       Brand 1: Brand 2: Brand 3: 15. Do you offer complexion analysis/imaging services for facial rejuvenation and skincare regimens?       Yes  No        What equipment do you own?       Type 1: Type 2: 16. Do you offer laser procedures? Yes  No        What type of laser do you own?       Type 1: Type 2: Type 3: 17. Do you offer microdermabrasion procedures? Yes  No        What equipment do you own?       Type 1: Type 2: 18. Do you offer soft tissue augmentation? Yes  No 19. Do you offer Botox? Yes  No 20. How many months in advance are you booked up? 21. Do you have a newsletter? Yes  No 22. Do you do external marketing? Yes  No 23. Do you do internal marketing? Yes  No 24. Names and titles of medical staff: Name Title 1.   Office Manager 2.   Surgical Nurse Assistant 3.   Receptionist 25. Do you have an esthetician working in your practice? Yes  No 26. Can your practice handle an incremental        increase of 150 new surgical patients/year? Yes  No 27. Can your practice handle 500 new skin care patients per year?Yes  No 28. How would you describe your office decor? 29. Do you have a PR plan? Yes  No 30. Do you offer patient financing? Yes  No 31. Do you have a merchant account for accepting credit cards?Yes  No       If yes, are you satisfied with your rates?Yes  No 32. What top ten surgeries do you offer Name 1. 2. 3. 4. TOP 10                              5. 6. 7. 8. 9. 10. 33. What procedures do you offer? Name 1. 2. 3. 4. 5. 34. Would you offer more procedures if you could get preferred discounts on equipment? Yes  No 35. Name your top three practice goals: Goal 1. 2. 3. 36. Name your top three personal goals: Goal 1. 2. 3. 37. Are you happy with the operation of your practice? Yes  No 38. Is there anything else that you would like to tell us?     39. Who refered you to this website?