Step 1 of 4

First Name *

Last Name *

Phone *

Email *

Practice Name *

Practice Website *

Your Position *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business. Message frequency varies, data rates may apply, and reply STOP to opt-out.

Step 2 of 4

How Did You Hear About Dr. Nick/LVRG Media and What Triggered You To Schedule This Strategy Session? *

What is your average number of patient VISITS per WEEK? *

What Is Your GOAL Number Of Patient Visits Per WEEK? *

What is your average number of NEW PATIENTS per MONTH? *

What is your GOAL number of NEW PATIENTS per MONTH? *

How Much In Collections Have You Averaged Per Month In The Past Six Months? *

What top three places do your new patients come from? *

Step 3 of 4

Are you currently running any Google Ads? If yes, how much is your monthly budget? *

Are you currently running ads on Facebook? If yes, how much is your monthly budget? *

Are you currently working with a different agency? If so, what is their monthly agency fee? *

Are you advertising on any other platforms? If yes, what platform? *

What monthly ad budget do you believe is ideal for reaching your goals? *

Final Step

In a perfect world, what would you like to accomplish in the next 12 months when it comes to your online marketing? *

Why is now the time to do something about your online marketing? *