First name
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Last name
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Email
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Phone
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What type of business do you run?
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Clinic
Weight Loss Clinic
TRT Clinic
Other (please specify)
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How many new patient consultations are you currently booking per month?
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0-20
20-50
50-100
100+
What’s your current monthly revenue?
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$0 - $25k/m (Please do not book. Your call will be automatically cancelled)
$25k - $50k/m
$50k - $100k/m
Are you 100% able to show up at the time you selected? (We do NOT offer reschedules - if you no show then our internal system automatically blocks your IP address from being able to rebook)
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Yes I will 100% show up
No I will not show and I don't want to book again
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