ExecTech Client - Marketing Questionnaire
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Name
*
First Name
Last Name
Position
Practice Name
*
1. Do you review the results of your new patient sources and promotional activities each week?
2. How many new patients do you average per month from patient referrals?
3. How many new patients do you average per month from professional referrals?
4. How many new patients do you average per month from the internet?
5. How many new patients do you average per month from your website?
6. How many new patients do you average per month from managed care provider lists?
7. How many new patients do you average per month from your building sign?
8. How many new patients do you average per month from outside events, such as community activities or talks you give?
9. How many new patients do you average per month from paid advertising?
10. What other types of promotional activities do you do?
11. How many new patients do you average per month from these?
12. What, if anything, do you or your staff do to encourage patients from referrals?
13. What, if anything, do you or your staff do to encourage patients from other professionals?
14. What, if anything, do you or your staff do to arrange outside events?
15. Who designed your website?
16. In what ways could your website be better?
17. Who manages your website?
18. What promotional methods have you used in the past that were ineffective?
19. What promotional methods have you stopped using that were effective in the past?
20. What groups and organizations do you belong to?
21. What leadership, volunteer or staff positions have you had with these groups?
22. What is special or unique about your practice? Why is your practice better than average?
23. Do you promote these special qualities in any way?
24. What are your goals regarding your practice promotional efforts?
25. What problems do you need to overcome to reach these goals?
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