Dentist Partner Pros

New Client Onboarding Form

Full Name *

Dental Practice Name *

Dental Practice Address *

The last two years of production and collections. *

How many active patients does your practice have? *

Average number of new patients per month? *

How many operatories does your practice have? *

Practice Management System *

Dental Practice Website

What is your working overhead %? (Before Dr. is paid) *

How many total team members do you have in your practice? *

How many assistants work in the practice? (Please clarify if they work part-time or full time, and if they have extended functions or not)

Please list all main technology and equipment used in your practice. *

What year did you graduate from Dental School? And what is your alma mater? *

When did you purchase your practice? *

How many days a week do you anticipate the associate working? *

Can you provide a list of anticipated benefits you plan to offer to the Associate. *

Please tell us something unique about your practice *

What insurance companies do you accept?

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