This field is hidden when viewing the formContact IDThis field is hidden when viewing the formName First Last How far out is the doctor's schedule completely full?(Required)How far out is the hygiene schedule completely full?(Required)On average, how many patients does the doctor see per day?(Required)On average, how many patients does hygiene see per day?(Required) Does your practice tend to run behind schedule?(Required) Yes No Do you pre-block your schedule?(Required) Yes No Is the doctor and assistant time scheduled separately in your practice management software?(Required) Yes No What is your active patient count?(Required)Calculate using patients seen in the past 18 months.What percentage are adults?(Required)Percentage of active patients over 18 What are the total number of minutes scheduled for an adult hygiene appointment?(Required)What are the total number of minutes scheduled for a child hygiene appointment?(Required) What is your total number of D0150 (Comprehensive Pt Evals) in the past 12 months?(Required)How many total hours per week do you offer in hygiene?(Required)Do any hygienists utilize an assistant and work out of two operatories?(Required) Yes No