T2 Consulting - Get Started Form

Please complete this short informal questionnaire and we'll contact you shortly

Fields with (*) are required.

Name *

Address

City

State

Zip Code

Phone

Fax

Email Address *

1. Dental Specialty

2. Number of Dentists in your practice?

3. Number of Hygienists in your practice?

4. Number of Assistants in your practice?

5. Number of Business Staff in your practice?

6. Number of Operatories in your facility?

7. Are you right-handed or left-handed?

8. I am using the following type of dental light. (check one)

Overhead track
Fixed ceiling mount
Chair mount
Other

9. Primary Dental Supplier?

10. Secondary Dental Supplier?

11. Have you considered any preliminary budget requirements for you project?

Yes
No

12. If yes, what is your preliminary budget?

13. Do you currently own a intraoral camera system?

Yes
No

14. If yes, what brand?

15. If a cart based system, do you feel it is as efficient as it should be?

Yes
No

16.What features of an intraoral camera are most important to you ?

17. Any interest in CDI, DVD, or VCR patient education programs?

Yes
No

18. Have you considered a multiple operatory video network system?

Yes
No

19. Any interest in Cable TV, Digital Satellite Systems or a VCR for patient entertainment ? Relaxation?

Yes
No

20. Are you currently using practice management software options?

Yes
No

21. If yes, which software package are you using currently?

22. Are you considering other practice management software options?

Yes
No

23. If yes, which software package are you considering?

24. Do you have any interest in a consulting group that specializes in helping dentists select the best practice management software program(s) for their office needs?

Yes
No

25. Do you currently own a website for your practice?

Yes
No

26. If yes, are you satisfied with its aesthetics, function and effectiveness?

Yes
No

27. Would you like T2's help designing a website specifically for your office?

Yes
No

28. Create a "Top 5" wish list (#1 being most important) of technology products that you would like to integrate into your practice.

29. Do you prefer more simplified technological systems (with fewer options available) involving mostly button pushing?

Yes
No

30. On average, how many hours a week do you devote to computer related functions?

31. Are there any other systems requirements that we should know about?

32. How can we assist you in meeting your high tech goals?

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