PracticeBuilders - The nation's leader in healthcare-practice success since 1979

If 13 questions could help increase your revenue by 10% to 50% in the next 12 months… (Well, how fast can you type?).

Find out whether you're missing out on opportunities to increase your referrals, attract more cash-paying cases or out-compete POPs by completing the following Practice Marketing Assessment. When you're done, we will evaluate your situation and provide a FREE Marketing Needs Analysis. If you'd like to speak directly with one of our Program Consultants, call 800-865-1494.

1. Which of the following best describes your situation?
   • I would like to grow my practice with more patients
   • I would like to grow my practice with more of a specific type of patient
   • I need to counter the effects of POPs and aggressive competitors
   • I want to dominate my area
   • I am in a group practice and making marketing decisions is difficult
   • I plan to retire within the next 10 years and want to build the value of my practice for eventual sale
   • My practice is healthy but we're always on the lookout for ways to work smarter, not harder
2. Marketing is no longer optional
   • I agree
   • I'm not sure
   • I disagree
3. What is your gross revenue growth goal over the next 12 months?
   • Over 100%
   • 50% to 100%
   • 25% to 50%
   • 25% or less
4. Does your practice have a written marketing plan?
   • Yes
   • No
5. How would you rate your current marketing program?
   • Highly effective: I have a plan and I'm reaching my goals.
   • Somewhat effective: inconsistent effort or results.
   • Not effective: no plan and no measurable results.
   • NA: I do not have a marketing program.
6. How often do you ask new patients how they heard about you?
   • Always: I have a foolproof routine in place.
   • Sometimes: inconsistent and/or irregular monitoring.
   • Never: We're not in the habit/don't have time.
7. How do most of your new patients find you?
   • Advertising and public relations
   • Patient referrals
   • Professional referrals
   • Insurance listings
   • Not sure/unknown
   • Other
8. Is competition an issue?
   • Yes
   • Not Sure
   • No
9. Are you a:
   • Solo PT Practitioner
   • Member of a group practice with one partner or associate
   • Member of a group practice with two or more partners or associates
   • Other: (please explain):
10. What has the revenue growth trend been for your practice over the past 24 months?
    • Up strongly: Annually 25% or more ahead of prior year.
    • Up somewhat: Annually about 10% ahead of prior year.
    • Generally flat: No significant change from year to year.
    • Down somewhat: Down by about 10% from previous year.
    • Significantly down: Down by 25% or more from previous year.
11. How would you rate your staff?
    • Tremendous asset
    • Good, not great
    • Inconsistent
    • Needs help
12. What is your estimate of your current marketing budget? (Ads, gifts, website, incentives, etc.)
    • $0 - $5,000
    • $5,000 - $15,000
    • $15,000 - $30,000
    • $30,000 - $50,000
    • $50,000 - above
13. What is your desired timeline for implementing some new or different marketing ideas?
    • Yesterday
    • 30-60 days
    • No hurry - more than 60 days

Please provide the following information. Your survey results cannot be calculated without it.

^* Required

• ^*Name
• ^*Are you the practice owner
  • Yes
  • No
• If you're not the owner, what is your role in the practice?
• Practice Owner's Name
• Profession
• Specialty (if any)
• Practice Name
• ^*Address
• ^*City
• ^*State
• ^*Zip
• ^*E-mail
• ^*Phone
• Fax
• Best time to call
• Best number to call
• Home Phone (optional)
• Cell Phone (optional)

How did you hear about PhysTherapists.PracticeBuilders.com?

• Please Select E-mail Direct Mail News Article Professional Referral Magazine Ad Web Site Staff Member Search Engine Friend
• Please Provide More Detail:
  Example: Name of Publication, Search Engine Used, Web Site Name, Email Topic, Etc.
• Other: (Please specify)