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Clinical Director Leadership Build-Out

Full Name
Practice Name
Email Address
Phone Number
Website
City/State

How many clinicians are currently on your team?
What is your current annual revenue?

Do you currently have someone functioning as a Clinical Director?

Do you currently have someone functioning as a Clinical Director?
A
B
C
D
E
If yes, who currently oversees clinician performance, productivity, and accountability?

Which areas are creating the biggest challenges today? (Select all that apply)

Which areas are creating the biggest challenges today? (Select all that apply)
What concerns you most about your current clinical leadership structure?
Do you currently track clinician productivity?
Do you currently track utilization?
Do you currently use dashboards or scorecards?
How confident, on a scale from 1-10, are you in your current reporting systems?
What would success look like six months from now?
If we worked together what would be the biggest win for your practice?
Why do you feel now is the right time to address these challenges?
Are you willing to commit to a six-month implementation process?
How did you hear about the Clinical Director Leadership Build-Out?
Is there anything else we should know about your practice before reviewing your application?