Seidel Agency's More Paying Patients System

1

What type of practice do you have?* This field is required.

Medical Spa

Dermatologist

Plastic Surgeon

Other

2

Do you know who your target audience is?* This field is required.

No

Not Sure

Yes

3

Is your target demo on social media?* This field is required.

No

Not Sure

Yes

4

Do you have any upcoming specials or promos planned?* This field is required.

No

Not Sure

Yes

5

What is your website?* This field is required.Please make sure it's a valid URL.

Example: https://www.example.com

6

What city and state are you located in?* This field is required.Please share full name. For Example: Philadelphia, PA

7

How competitive is your industry there?* This field is required.

No competition

Average

A few competitors

Extremely competitive

8

How affordable are your products and services?* This field is required.

Frequent Discounts & Groupons

Average

Above average pricing

Top of the Line

9

What non-invasive treatments do you offer?* This field is required.Please select all of the treatments you currently provide. Scroll down for more options.

Neurotoxins (Botox, Dysport, NewTox)

Facial Fillers (Restylane, Juvederm, Versa)

Injections (Kybella, PDO Threads, PRP)

Bodysculpting (Coolsculpting, Emsculpt, truSculpt)

Lasers

RF Microneedling

Facials & Peels

Skincare (Alastin, Obagi, ZO Skin, etc)

Other

10

What surgical procedures do you offer?* This field is required.Please select the types of surgeries you provide, or choose "Not Applicable" if none.

Face Lift

Brow Lift

Body Lift

BBL

Not Applicable

Other

11

How is your social presence?* This field is required.

Non-existent

Barely active

Somewhat active

Crushing it!

12

How much content do you have?* This field is required.Before / Afters, Tutorials, Treatments, Office, Staff, Patient Testimonials

Little to none

Average amount

Decent stockpile

Tons of it!

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A few more simple questions and we're all done ...

14

How would you rate your internal sales process?* This field is required.

Not great

Average

Above average

Crushing it!

15

How well-known is your practice or physician?* This field is required.

Just starting

Building a name

Somewhat recognizable

KOL superstar

16

How motivated are you to grow your practice?* This field is required.On a scale of 1-5, with 5 being 'extremely' and 1 being 'not at all.'

1

2

3

4

5

17

Do you currently have sales?* This field is required.If you're just opening up, that's totally fine.

YESNO

18

What are your currently monthly sales?* This field is required.

0 - $30K

$30K - 100K

$100K - $250K

$250K+

19

What best describes your current situation?* This field is required.

I'm ready to invest in our practice

I'd like to invest, but not sure I have budget

I'm looking for information

20

Please enter your contact information, and we'll follow-up with answers.

21

Full Name* This field is required.

First Name

Last Name

22

E-mail* This field is required.

example@example.com

23

Phone Number* This field is required.Please share a phone number with texting capabilities.

Please enter a valid phone number.

24

Thank you. For anything additional, please email Marketing@TheSeidelAgency.com

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