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LJR Dental Consulting
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Intake form
Help us serve you better
Name
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Email address
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What are your primary areas of interest for consulting?
Please select at least one option.
Clinical Systems
Leadership Development
Revenue Transparency
Insurance Exit Strategy
What is the size of your dental practice?
Select
1-5 employees
6-10 employees
11-20 employees
21+ employees
What type of dental practice do you operate?
Select
General Dentistry
Specialty Dentistry
Pediatric Dentistry
Orthodontics
Oral Surgery
What challenges are you currently facing in your practice?
How did you hear about LJR Dental Consulting?
Select
Referral
Social Media
Search Engine
Networking Event
Which service or services are you interested in?
Please select at least one option.
Clinical systems
Leadership development
Revenue transparency
Insurance exit
Additional questions or comments
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