Doctor Questionnaire « ePractice Manager | Systems for next-level growth

We will soon be doing an in-office consultation at your practice. Doctor input is extremely useful in understanding a practice and is necessary in making our consultation as productive as possible. Therefore, we would appreciate it if you would take the time to fill out this short questionnaire.

Date*
MM slash DD slash YYYY
First Name*
Last Name*
Email*
Practice Name*
How long have you been in practice?*
How much longer do you plan to practice?*
What, if any, areas of the practice do you feel may slow down your production, or are less efficient than you would like? Please explain.*
What do you feel is your potential for growth on an annual basis?*
What issues or challenges do you see that need to be addressed to achieve this growth?*
Please give us any feedback, negative or positive, about any particular staff that you feel will be helpful in getting a clear picture of performance, or issues that may need to be addressed.*
Please list names and issues on each that you wish to note.
Please tell us about any associate related issues that you see within the practice.*
How do you feel about your ability to get compliance from your staff, and do they generally carry out your instructions in a timely manner?*
How do you feel about your ability to attract new patients to the practice?*
Pleases tell us about your goals for the practice over the next 3-5 years?*
Note: Your statement of goals doesn't necessarily need to be stated in terms of numbers, e.g., What is your vision for the future? It can include anything from bringing in associates, purchasing other practices, to plans for retirement, etc.
Are there any other particular areas or situations within the practice that you wish to discuss?*