Questionnaire // Telos Digital Marketing

Please complete the form below so we can get a better understanding of your practice.

Name

Practice Name

Phone Number

How many new patients are you getting in a month?

How many new patients would you LIKE to add in a month?

What area does 80% of your patients come from? How far from your office?

What is your current patient demographic? (age, gender, location, etc.)

What are your top services?

What service or services do you want to promote more?

What is your main source of new patients? (TV, Radio, Referrals, Digital Marketing, etc.)

What are you currently doing to market your practice?

What is your current marketing budget?

What makes you stand out from the competition?

Who are your main competitors? What are their strengths and weaknesses?

Is your practice?

Growing Steady Declining

What's the #1 challenge to growing your practice right now?

Where do you want the practice to be in 12 months?

Are you currently using a CRM (customer relationship management) or email automation software?

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No one outside of the Telos Digital Marketing team will ever view this application.