Name
*
First Name
Last Name
Email
*
Big Picture: Why are you interested in coaching?
Select the statement below that best describes your situation
If other, please explain:
What would you be willing to do to grow your practice? (Select all that apply)
How many patients do you see per hour? What format are these exams? (Comprehensive/Short Visit/etc.)
How long do you take for a lunch break? Do you close for lunch?
What is your no-show percentage? How many reschedules do you have per day? When do the most no-shows occur?
How many (full) exams do you complete per day? How many encounters?
What is the square footage of your current location? What is your revenue/square footage per year?
How many exam rooms do you have?
Please describe your work up space.
Please Provide your Costs of Goods Sold totals for: Optical Lab, Frames, Contact Lenses
What is your anti reflective %?
What is your photochromic percentage?
Rank your contact lens sales by wear schedule (Daily vs 2 week vs Monthly)
What percentage of CL sales are an annual supply?
Please provide: Staff Salaries/Expenses as a % of revenue, Revenue per staff person, Revenue per hour. (Include only full time equivalent staff for the last two, 2000 hours= one FTE)
What percentage of Revenue do you spend on: Overhead? Occupancy? Patient Care/Equipment? Advertising?
Please provide your revenue totals: per exam, per encounter, per day, per doctor.
Collections: What percentage of your AR is less than 30 days? What percentage is 30-60 days? Over 60 days?
