Service Confirmation & Booking Form
Welcome to TheraBizSolutions. Thank you for choosing the Complete Practice Growth System. Please complete this form so the team can collect the basic information needed to begin onboarding and initial strategy. This form does not process the $9 booking fee; after submitting, return to the service package webpage and scroll to the bottom of the page to complete the $9 booking fee payment. Your booking will be considered confirmed once the form has been submitted and the $9 booking fee has been received. No service payment is required for Month 1.
Basic Information
Full Name
*
First Name
Last Name
Professional Title
*
Practice / Business Name
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Professional Background
What is your primary specialization or area of expertise?
*
What services do you currently offer?
*
Who are your ideal clients?
*
Briefly describe your professional approach, philosophy, or style.
Your Current Digital Presence
Main professional social media profile(s)
Current status of your website
*
I have a website and want to continue using it
I have a website but it needs improvement
My website is currently under development
I do not currently have a website
Google Business Profile
*
Yes
No
I'm not sure
How are you currently marketing your practice?
Programme Confirmation
Which programme are you proceeding with?
*
Complete Practice Growth System — $1,990
Do you want to add the optional custom website?
*
No — I will use my existing website
Yes — I would like the fully custom website for $500
I do not have a suitable website yet and would like to discuss the website option
How do you prefer our team to communicate with you?
*
Email
WhatsApp
Phone / Voice Call
Video Meeting
What U.S. time zone are you in?
*
Please Select
Eastern Time
Central Time
Mountain Time
Pacific Time
Alaska Time
Hawaii-Aleutian Time
Other
Your Goals
What are the most important goals you want us to help you achieve?
*
Is there anything else you would like our team to know about your practice or business?
Confirmation & Understanding
Please Confirm the Following
*
I understand that the $9 booking fee is paid separately on the service package webpage after I submit this form.
If I selected the optional website, I understand that the $500 website payment is due after the completed website has been delivered.
I understand that the programme is designed so that my direct involvement in the implementation is minimal, while our team handles the majority of the planning, content creation, creative production, marketing implementation, and ongoing management.
I confirm that the information I have provided is accurate to the best of my knowledge and that I am ready for the TheraBizSolutions team to begin the onboarding and initial planning process after my booking is confirmed.
Please verify that you are human
*
Submit
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