This field is hidden when viewing the formContact IDThis field is hidden when viewing the formName First Last How many new patients do you CURRENTLY see monthly?(Required)Average of the last 6 monthsHow many new patients WOULD YOU LIKE to see monthly?(Required) How many days do you CURRENTLY work per week?(Required)How many days WOULD YOU LIKE to work per week?(Required) How many vacation weeks do you CURRENTLY take per year?(Required)How many vacation weeks WOULD YOU LIKE to take per year?(Required) What is your CURRENT annual practice production?(Required)What is your GOAL for annual practice production?(Required) What is your CURRENT annual practice collections?(Required)What is your GOAL for annual practice collections?(Required) Do you have a daily production goal for your practice?(Required) Yes No What is your daily production goal?(Required) What are your feelings regarding the growth of your practice to date?(Required) What are your feelings regarding the current net income from your practice?(Required)