What is your practice name? *

What is your website URL? *

What is your first name? *

What is your position at the practice? *

• Owner
• Associate
• Practice Manager
• Marketing Manager
• Assistant
• Other
• No elements found. Consider changing the search query.
• List is empty.

What is your practice type? *

• Plastic Surgery
• Plastic Surgery + Medspa
• Medical Spa
• Refractive Surgery
• Dermatology
• Other
• No elements found. Consider changing the search query.
• List is empty.

Which EMR do you currently use? *

ModMed

Nextech

Patient Now

Aesthetic Record

What are you using for a CRM, marketing automation platform, or lead tracker? *

Spreadsheets

MyMedLeads

Constant Contact

NextechCRM

EZtexting

How many users would you expect to have using the software on a daily basis?

• 1
• 2
• 3
• 4
• 5
• 6
• 7
• 8
• 9
• 10+
• No elements found. Consider changing the search query.
• List is empty.

What is your last name? *

How many locations do you see patients in? *

• 1
• 2
• 3
• 4
• 5
• 6
• 7
• 8
• 9
• 10+
• No elements found. Consider changing the search query.
• List is empty.

Where are you located? *

Are you interested in advertising? *

• Yes
• No
• Already Running Ads
• No elements found. Consider changing the search query.
• List is empty.

What is your email? *

What is your cell phone number? *

Would you like your practice secret shopped? *

• Yes
• No
• No elements found. Consider changing the search query.
• List is empty.

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