Mastermind Application

Full Name*

Practice Name*

Email*

Phone*

How many offices do you have?*

How many partners do you have?*

Do you specialize in any field?*

How many employees do you have (per department)? *

Last 12 Months of Collections*

What is your Collections Goal?*

What practice management software do you use?*

Who referred you to All-Star Dental Academy?*

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

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

What are 3 areas you want to improve?*

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)?*

Have you taken your team to dental events? If so, which ones and how often?*

What marketing company do you work with?*

What time of day and/or day of the week are your team meetings held?*

How often are your time meetings (not counting daily huddles)?*

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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