check

Business Diagnostic Form

Please take time to fill in the following form ahead of your first mentoring session

Click the button below to start.

Start

Question 1 of 50

Please enter your name, practice name and practice address and telephone number.

Question 2 of 50

Your details - please enter your best email address and personal contact number

Question 3 of 50

What is your practice website url? How old is this website?

Question 4 of 50

Business Overview - What sort of health business do you currently own?

Question 5 of 50

Do you have any team members? If yes, please list the number of admin and clinic therapists and state whether they are full time or part time.

Question 6 of 50

Do you have a systems manual that explains the main functions of the business?

A

Yes

B

No

Question 7 of 50

What specific health professionals are involved in your practice?

Question 8 of 50

What are your current opening hours and days of operation and fees?

Question 9 of 50

What do you believe to be the unique selling proposition of your business – i.e. why should your clients choose your business over your competition?

Question 10 of 50

Describe your ideal client in as much detail as possible.

Question 11 of 50

What are the current strengths of the business?

Question 12 of 50

What are the current weaknesses of the business?

Question 13 of 50

Where so you see the biggest opportunities for future growth of your business?

Question 14 of 50

Do you offer your clients pre-pay or pay in advance programs?

Question 15 of 50

Do you have a referral rewards program? If so how does it work?

Question 16 of 50

What is your current monthly turnover?

Question 17 of 50

What is the status of your current clinic location – ie do you own your office or pay rent etc.  Do you rent rooms out to other therapists? If yes, how many rooms and what rental income does it bring into the business?

Question 18 of 50

What are your current pre tax monthly profits?

Question 19 of 50

Does you employ any staff? (A virtual receptionist counts). What is your current monthly wage bill?

Question 20 of 50

What is your current monthly rent/mortgage  as a % of gross? (Rent divided by total monthly income, then multiply by 100).

Question 21 of 50

What are you biggest monthly expenses outside of wages and rent?

Question 22 of 50

How many new patients do you see each month?

Question 23 of 50

What are your new clients main referral sources – i.e. where do the majority of your new patients come from?

Question 24 of 50

When did you last increase your fees and by how much?

Question 25 of 50

How do these fees compare to other similar providers in your local area?

Question 26 of 50

How many treatments does your clinic perform each month?

Question 27 of 50

What is your clinics patient visit average – i.e. how many times does each client come into your clinic each year?

Question 28 of 50

What is your individual therapists patient visit averages?

Question 29 of 50

What is your current clinic utilization rate? I.e. what % of your available rooms are being used each week?

Question 30 of 50

What is your current therapist utilization rate? I.e. what % of your therapist’s available time is being booked and used each week? If it's just you, what % of your available treatment time is booked and used each week.

Question 31 of 50

Do you use GaitScan, Ultrasound, IDD Therapy, Shockwave Therapy or any other assessment or treatment technology?

Question 32 of 50

Nearly there - this last section is : A little about you - this is important as business mentoring is as much about the person being mentored as the business.

Please record your relationship status. Do you have children? If so - how many and how old are they?

Question 33 of 50

How much time do you spend with your family and friends each week?

Question 34 of 50

Do you feel that you are missing out on important family activities and occasions because of your business commitments?

Question 35 of 50

Do you currently treat patients yourself  in your practice? If so how many hours a week?

Question 36 of 50

How many hours a week do you spend on the other aspects of the business such as staff management, systems development and administration?

Question 37 of 50

How many hours a week do you spend on marketing activities and practice growth activities?

Question 38 of 50

Do you often work weekends and late at night to finish work tasks? If so how often and for how long?

Question 39 of 50

What are your biggest weaknesses as a health professional and business owner?

Question 40 of 50

What are you biggest strengths and weaknesses as a person?

Question 41 of 50

What are your biggest strengths as a health professional and business owner?

Question 42 of 50

What is holding you back from achieving your business and life goals?

Question 43 of 50

If you could have anything what would it be?

Question 44 of 50

If you could have more personal time - what would you like to do with it?

Question 45 of 50

Do you have one year goals for your monthly gross income, weekly consult number, monthly pre tax profit and monthly new patient number? If so what are they?

Question 46 of 50

What do you want your life to look like in 1 year from now?

Question 47 of 50

What do you want your life to look like in 3 years from now?

Question 48 of 50

Is there anything else that you would like to add that will help me structure the best possible course of action for you and your health business?

Question 49 of 50

Last Few Questions - The Mentoring Program

What are the 5 main things you would like to work on in our coaching program?

Question 50 of 50

How many hours each week do you think you can devote to your homework, call preparation and tasks – be realistic please?

Confirm and Submit