Apply for a Practice Diagnostic

Before we begin, we need to determine whether your practice is a good fit for our diagnostic process. This application takes approximately 3 minutes. Because our analysis relies on data, not every practice qualifies.

Please enable JavaScript in your browser to complete this form.

Practice Name *

Website *

Primary Contact *

Role *

Email *

How have your

Phone *

How many providers work in the practice? *

How many operatories? *

Approximate annual practice revenue *

Which Practice Management System (PMS) do you use? *

Can you export reports or CSV data from your PMS? *--- Select Choice ---YesNo

Do you have access to production and collections reports? *--- Select Choice ---YesNo

Do you have access to provider-level reporting? *--- Select Choice ---YesNo

Do you have access to scheduling data? *--- Select Choice ---YesNo

Please acknowledge the following: *

• This is a paid diagnostic engagement.
• The diagnostic requires practice data for analysis.
• Results depend on implementation by the practice.
• The guarantee relates to identifying opportunities for improvement and does not guarantee specific financial outcomes.

Anything else we should know about your practice?

Submit Application