Partnership Questionnaire

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Please trust the process even if these questions feel annoying or nosey! Coaching is about trust – connection and communication! The more I know about you the better I can communicate – connect and grow trust with you! We are growing your business, your future wealth, your family’s financial stability, your passion, your dreams and your legacy! Take the time to give me the real you and I will invest in it!

Partnership Questionnaire

Company Name(Required)

Owner Name(Required)

First Last

Owner Contact Number(Required)

Owner Contact Email(Required)

DISC - Personality Type(Required)

(describe here if you don’t know exact profile type)

Years Owned(Required)

Years Practicing(Required)

What generation dentist are you?(Required)

Anyone else in family in dental field?(Required)

Yes

If yes, please share here(Required)

Days per week(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

check box for each day

Hours(Required)

Location(s)

Preferred days for calls(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

check box for each day

Best time for coaching calls(Required)

12:00 -1230

12:30-1:00

1:00-1:30

5:00-5:30

5:30-600

6:00-630

6:30-7:00

7:00-7:30

7:30-800

Any

may select multiple times

Best form of communication during work day?(Required)

Call

Text

Personal/Family

Tell me something’s that you want me to know about you on a personal level (colleague to colleague ) Give me some family values - upbringing - motivators ! I want to make sure I understand you and you and I align on what’s important for you in this coaching plan !!(Required)

Spouse's Name(Required)

Spouse's Career(Required)

Kids Names and Ages(Required)

Do you have a will in place and is it current?(Required)

Yes

Do you have adequate life insurance coverage?(Required)

Yes

If no, why?(Required)

What is your Buy- Sell agreement with your partners in case of death, disability, retirement, other?(Required)

Are you comfortable with your income?(Required)

Yes

If no, what number would get you comfortable?(Required)

Business Owner Partner

Tell me something that you absolutely want me to know about you professionally?(Required)

(Past- Present-Future)

What motivates you to work on your business?(Required)

What areas of the business do you best thrive in?(Required)

Employee Management

Employee Retention

Team Training

Recruitment

Legal

Accounting

Bookkeeping Reporting

Recording

Practice Growth

Marketing

Technology

Products

Materials

What areas of the business are pain points for you?(Required)

Employee Management

Employee Retention

Team Training

Recruitment

Legal

Accounting

Bookkeeping Reporting

Recording

Practice Growth

Marketing

Technology

Products

Materials

What areas of your business and practice do you want to learn more about?(Required)

Employee Management

Employee Retention

Team Training

Recruitment

Legal

Accounting

Bookkeeping Reporting

Recording

Practice Growth

Marketing

Technology

Products

Materials

What hidden talents are you not using in your company?(Required)

Dentist Provider

What motivates you to work in your business?(Required)

What age would you like to be financially ready to retire?(Required)

How many years do you anticipate working full time as a provider?(Required)

Do you have any body aches and headaches you want me to know about?(Required)

(all dentists have some type of last injury, current pain, or future concern with pain in your head! Tell me what it is so we can be prepared!)

Tell me how you keep yourself mentally and physically healthy for your patients - your team and your family!(Required)

Would you share with me some of your professional goals for the next 3 years?(Required)

(where do you see yourself and do you have a plan in place to get there)

What dental services do you enjoy doing most?(Required)

What services do you tend to refer out?(Required)

Do you refer to your partners who do those services? How does that work?

How much time do you schedule for NP Hygiene?(Required)

How much time do you schedule for Limited Exam?(Required)

How much time do you schedule for Emergency?(Required)

How much time do you schedule for Posterior Filling(s)?(Required)

How much time do you schedule for Crown Prep?(Required)

How much time do you schedule for Crown Seat?(Required)

How much time do you schedule for Bridge?(Required)

How much time do you schedule for Implant Placement?(Required)

How much time do you schedule for Implant Crown?(Required)

How much time do you schedule for Implant Delivery?(Required)

How much time do you schedule for RCT Posterior?(Required)

How much time do you schedule for RCT Anterior?(Required)

How much time do you schedule for Veneers? (4-6 teeth)?(Required)

How much time do you schedule for Veneers? (6-12 teeth)?(Required)

How much time do you schedule for FMR?(Required)

Hygiene Times

How much time do you schedule for Perio Quad?(Required)

How much time do you schedule for Perio Maintenance?(Required)

How much time do you schedule for Adult RC?(Required)

How much time do you schedule for Child RC?(Required)

How much time do you schedule for Adult NP?(Required)

How much time do you schedule for Child NP?(Required)

Tell me about the health or your dental hygiene department(Required)

Tell me about the health of your patient base(Required)

How do you divide up patients?(Required)

How are new patients split up?(Required)

How far out is your provider schedule booked?(Required)

What is your monthly production goal?(Required)

What’s your company’s average monthly collections?(Required)

What’s your monthly collection goal?(Required)

Are you on track for your company goals?(Required)

Yes

What is your current overhead %?(Required)

What percentage of your practice has undiagnosed periodontal issues?(Required)

(estimate)

What percentage of your patient are in active therapy?(Required)

(estimate)

What new services would you like to bring to the office within the next 3 years?(Required)

What CE are you most interested in taking to improve your existing skills or to add new services to the practice?(Required)

What 3 words would you like to use to describe each of the following:

(your perspective)

Your Business:(Required)

Your Team:(Required)

Your Patients:(Required)

What 3 words would you currently use to describe each of the following:

(your perspective)

Your Business:(Required)

Your Team:(Required)

Your Patients:(Required)

When you think about the future of your company (1-5 years) what do you think it should look like(Required)

(your perspective)

How do you and your partners communicate?

Group email

Group text

Group App

Group Calls

In person Weekly Meetings

In person Monthly meetings

In person Quarterly Meeting

How often do you meet with your office manager?(Required)

How involved are they with the business?(Required)

How involved are they with the practice growth?(Required)

Who does the employee reviews?(Required)

What’s the process

Do you have monthly team meetings?(Required)

Yes

If yes, how do they work?(Required)

Do you discuss numbers at meeting with your team?(Required)

Yes

How do you all determine pay increases for employees?(Required)

What are your employee benefits?(Required)

What type of bonus plans have you tried in the past or your friends have tried and felt were unsuccessful? Why?(Required)

How important is “Practice Culture" to you?(Required)

Very important

Important

Somewhat important

Not very important

Not important at all

How important is employee technical skills to you?(Required)

Very important

Important

Somewhat important

Not very important

Not important at all

How important is employee service knowledge to you?(Required)

Very important

Important

Somewhat important

Not very important

Not important at all

(being able to explain Risks - Benefits- Advantages for services)

Do you have expanded duties dental assistants in your practice?(Required)

Yes

How are they utilized in your work day?(Required)

How important is employee loyalty to you?(Required)

Very important

Important

Somewhat important

Not very important

Not important at all

How important are relationships to you in dentistry?(Required)

Very important

Important

Somewhat important

Not very important

Not important at all

Relationships and communication go hand and had in small business ! As your communication increases the relationship grows! We want you to have the most successful journey by partnering with Bryant Consultants and we will do our best to ensure it! It’s time to get started! Be on the lookout for a text from me soon and we will get our calls set up! Cheers to a great partnership !

Have Questions?

Schedule a call with one of our consultants today to find out how we can help!

First Name

Last Name

Partnership Questionnaire