Podiatry Profits Mastermind Application

1

Let's get started... What is your name?* This field is required.

First Name

Last Name

2

What is your Email?* This field is required.So we can communicate and you don't miss out my upcoming events.

example@example.com

3

Mobile Phone Number?* This field is required.We never spam :)

4

What is your practice website url?* This field is required.If you don't have one, please type "no website"

5

My TWELVE-MONTH GOAL for consistent monthly revenue is...* This field is required.

$10K - $20K / month

$20K - $40K / month

$40K - $60K / month

$60K - $80K / month

$80K - $100K / month

$100K - $150K / month

6

My CURRENT monthly revenue is (Please answer truthfully)....* This field is required.

STARTUP to $10K / month

$10K - $20K / month

$20K - $40K / month

$40K - $60K / month

$60K - $80K / month

$80K - $100K / month

7

What do you feel is your biggest obstacle to hitting your monthly revenue goal?* This field is required.(Please answer candidly)

8

What insurance plans are you working with if any?* This field is required.

9

How willing are you to invest in the growth of your practice right now?* This field is required.

10

On a scale of 1 to 10, here’s how COACHABLE I am...* This field is required.(1 = Not at all, 3 = Somewhat, 5 = “All-In!”)

11

If we are right fit to work together, how soon would you like to get started?* This field is required.