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Application for a 15 minute call with Julie Williams
1
Are you currently running your own business
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YES
NO
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2
What type of Practice Do you own?
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3
How long have you been running your own business?
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Less than 1 year
2-5 years
More than 5 years
I don't run a business
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4
What is your current revenue per year?
*
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$0 to $100,000
$100,000 to $250,000
$250,000 to $500,000
$500,000 to $1,000,000
$1,000,000 +
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5
What area of your practice do you need most help with right now Results/Retention or Revenue?
*
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Please choose your top priority as no 1 2as your second and 3 as your lowest priotity in the box below
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6
Your Name
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First Name
Last Name
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7
What is your best email address?
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example@example.com
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8
Where are you located?
*
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Please Select
Australia - East Coast
Australia - West Coast
Australia - South Australia
Australia - Northern Territory
New Zealand
United Kingdom
USA - Eastern Standard Time
USA - Mountain Standard Time
USA - Central Standard Time
USA - Pacific Standard Time
USA - Hawaiian Standard Time
Please Select
Please Select
Australia - East Coast
Australia - West Coast
Australia - South Australia
Australia - Northern Territory
New Zealand
United Kingdom
USA - Eastern Standard Time
USA - Mountain Standard Time
USA - Central Standard Time
USA - Pacific Standard Time
USA - Hawaiian Standard Time
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9
What's the best phone number to call?
*
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Please provide your country code, area code and phone number
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10
What kind of a situation are you in right now?
*
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I want more bookings
I want better results for patients
I want my practice to depend on me less
All of the above
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