WEEKLY PRE-CALL INTAKE FORM

Complete this before Wednesday 8PM - it shapes your session

1. What's your biggest bottleneck right now?

What is blocking your clinic's progress this week?

2. Which metric is stalled or declining?

Revenue / New Patients / Visits / Referral Rate / Cancellation Rate - pick one and give the number.

3. What are you avoiding or stuck on?

The conversation you're not having. The decision you're not making. The thing you know you need to do.

4. One win from last week

Anything that went right — big or small.

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