Skip to content
JTS Commercial Forms
"
*
" indicates required fields
Step
1
of
2
50%
Practice Name
*
Submitted by
*
First
Last
Email
*
1. Select the top 3 challenges your dental practice faces in the following areas. (Please select three from each section)
Front Office Experience
*
Appointment availability/wait time for appt.
Patient communication and education challenges
Inefficient patient scheduling - accuracy/no-shows/reminders
Payment collection
Insurance and patient demographics verification
Inadequate training on our current system
Lack of modern technology and equipment
After-hours coverage for emergency care
On a scale of 1-5 (1 being not disruptive, 5 being extremely disruptive), how much do your top 3 selected challenges impact your practice's day-to-day operations?
*
1
2
3
4
5
Patient Clinical Care Experience
*
Provider time management per patient (overbooked)
Patients asking for more provider time
Anxiety/Pain Management
Patient involvement via patient portal
Delays in patient flow from the waiting area to the room
Difficulties in charting/prescribing
On a scale of 1-5 (1 being not disruptive, 5 being extremely disruptive), how much do your top 3 selected challenges impact your practice's day-to-day operations?
*
1
2
3
4
5
Billing/Back Office Experience
*
Challenges managing insurance claims and billing
Poor performing practice management software
Under-trained/inexperienced coders and billers
Lack of data analytics tools/understanding of business metrics
Data integration and management
Major dental coverage/authorization
On a scale of 1-5 (1 being not disruptive, 5 being extremely disruptive), how much do your top 3 selected challenges impact your practice's day-to-day operations?
*
1
2
3
4
5
Staffing & Operations
*
High Employee turnover / Finding and retaining qualified staff
Training of new hires/length of time to become proficient in duties
Maintaining employee motivation
Inefficient workflows and processes
Inadequate or outdated facilities or equipment
Cybersecurity issues
Regulatory compliance
On a scale of 1-5 (1 being not disruptive, 5 being extremely disruptive), how much do your top 3 selected challenges impact your practice's day-to-day operations?
*
1
2
3
4
5
Financial & Growth
*
Declining reimbursements
Increasing overhead costs
Challenges collecting patient payments / Collection Process
Lack of data analytics tools/understanding of business metrics
Limited marketing and growth strategies
Inability to offer competitive pricing/financing
Offering financing options for higher-cost procedures
Adequate accounting/reporting to evaluate current status and establish goals in the future
Education on business processes
On a scale of 1-5 (1 being not disruptive, 5 being extremely disruptive), how much do your top 3 selected challenges impact your practice's day-to-day operations?
*
1
2
3
4
5
2. Rank the following challenges your practice faces
Patient acquisition and retention
Burnout
Revenue and Finances
Managing Technology
Extreme dental phobia
Time management
Marketing and competition
Compliance
3. What additional details can you share on the most significant obstacles you face in delivering exceptional patient care?
*
4. On a scale of 1-5 (1 being not confident, 5 being very confident), how confident are you in your practice's financial stability?
1
2
3
4
5
5. Which of the following might interest you? (Check all that apply)
Outsourcing practice management (e.g., billing, scheduling)
Outsourcing marketing
Surveying patient satisfaction
Practice management Consulting
Expanding the use of dental software/EDI solutions
Patient financing and automatic payments
