New Client Onboarding

Complete Your Onboarding Form

Please fill out the form below right away so we can get started! This will take less than 2 minutes!

Office Name *

What are your normal office hours? *

Office Address *

City *

State *

Postal code *

Name of Primary Dentist *

Dentist's Email *

Dentists Phone Number *

Name of Front Office Contact *

Front Office Email *

Front Office Phone Number *

Is there a dedicated office manager at the practice? *

Yes

Name of Office Manager *

Office Managers Email *

Office Manager Phone Number *

What do you value more? *

More Volume of Consults

Better Quality Consults

Please share some set times that we can book consultations for you each week. (Having one morning and one afternoon time is best so we can give patients a couple options) *

We'll also confirm these times with your front office so everyone is on the same page.

We require a "Free CT Scan & Consult" as a minimum offer to get people to show up. Please confirm this is OK: *

Yes, I approve

Please select your desired monthly ad budget. *

Note: If you are in a competitive market, we recommend a minimum $2,000+ ad spend for best results. This amount will be billed every 30 days starting when your campaigns go live. 100% of this amount is put towards running your ads. Bigger budgets = more results. You can increase/decrease this ad budget for any given month.

What insurances do you NOT accept that we should turn away? *

How often would you prefer we check-in with you? *

Some client’s prefer more regular communication and others are more hands off. How often would you like us to be in touch with you?

Invite Other Dentists & Get $500/Mo For Each Referral! (optional)

Is there anything that we have not asked about that you believe would be helpful for us to know? *