5-Minute Assessment – Dental Education Partners

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DEP 5-Minute Practice Assessment
How do you compare to industry standards? Take our 5-Minute Dental Practice Assessment to find out!
Name*
Owner Doctor Name
Email*
Phone
Which best describes your dreams:
- To practice the kind of dentistry you want
- Work with a team who supports your vision
- To live the life you want to live
- To own multiple practices

Practice Name*
Practice Name
Practice Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Hours of Operation
Number of Operatories*
Number of Providers (Dentists, Specialists, Hygienists)*
Average patient visits per month (#)
Average gross production per month ($)*
Average % of production from hygiene (% of total)
Average collections per month ($)*
Aging AR amount over 90 days
What does your payor mix include?
- Fee for service
- PPO
- Medicaid / Managed Care
- All of the above
Please describe your biggest concerns with the current state of your practice...
- Holes in the schedule
- Low collections
- Staff turnover
- You are working too many hours
Additional comments...

DEP 5-Minute Practice Assessment