Diamond Mastermind Application

Full Name*

Practice Name*

Email*

Phone*

How many offices do you have?*

Does you practice specialize in any particular field?*

How many team members do you have (per department)? *

What (if any) practice management training companies or products have you used in the past?*

Do you currently work with a coach/consultant? If so, what company?*

Do you take dental insurance? If so, what plans (and do you want to lessen dependence on insurance)?*

Who referred you to All-Star Dental Academy?*

Tell me about your practice. Is anything holding you back from reaching your goals?*

Why are you interested in joining the All-Star Diamond Mastermind?*

What are 3 areas you want to improve?*

How could you improve as a leader?*

What is your DISC Profile?*

DISC is a simple personality profile.
Here is a link to a quick free test.

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