CLIENT INTAKE & DISCOVERY FORMStep 1 of 16 - Practice Overview6%Practice OverviewLet’s start with the basics about your practice.Legal practice name(Required)Preferred brand name (if different from legal name)Practice website URL Primary office address(Required)Additional office locations (if any)Primary phone number(Required)General practice email(Required) Year the practice openedCurrent number of operatories / treatment roomsCurrent number of providers (doctors, hygienists, specialists)Approximate number of active patientsPractice management software usedContact & Decision-Maker InformationWho should we collaborate with throughout the engagement?Primary contact name and title(Required)Primary contact email(Required) Primary contact phone(Required)Who is the final decision-maker on marketing and branding approvals?Is there anyone else who should be included in strategy discussions? If yes, provide names, titles, and preferred contact methods.Practice History & Founding StoryTell us about your origin story and how the practice became what it is today.What inspired the founding of this practice? What gap or need did the founder see in the market?Tell us the founder’s personal journey into biological / holistic dentistry. What was the turning point?Has the practice evolved significantly since opening? Describe key milestones (expansions, new services, rebrand, philosophy shift, technology upgrades).Has the practice been featured in any media, publications, or speaking engagements? Please provide links or details if available.Is there a pivotal patient story or defining moment that shaped the practice’s direction?Mission, Philosophy & BeliefsWhat are the core convictions that drive your treatment decisions and patient communications?What is the practice’s mission statement (formal or informal)?Describe the practice’s philosophy of care in your own words. What do you believe about how dental care should be delivered?How does the practice view the connection between oral health and whole-body health?What conventional dental practices or materials does the practice deliberately avoid, and why?How does the practice’s philosophy directly affect the way treatment plans are created?Are there core beliefs the practice holds that you feel are underrepresented in your current marketing?What would you most want a potential patient to understand about how you think about care before they ever walk through the door?Services & Treatments OfferedHelp us catalog every service for SEO, ads, and website architecture.Which services does your practice currently offer? (Select all that apply) Comprehensive / New Patient Exams Preventive Cleanings & Hygiene Periodontal Therapy (Scaling & Root Planing) Safe Amalgam (Mercury) Removal (SMART Protocol) BPA-Free / Biocompatible Fillings Ceramic / Zirconia Implants Titanium Implants Full-Mouth Rehabilitation Biomimetic Dentistry Ozone Therapy PRF / PRP Therapy (Platelet-Rich Fibrin) Laser Dentistry Cavitation Surgery / NICO Surgery TMJ / TMD Treatment Airway & Sleep Apnea Treatment Orthodontics / Clear Aligners Pediatric / Children’s Dentistry Cosmetic Dentistry (Veneers, Bonding) Teeth Whitening Root Canal Alternatives Dental Crowns & Bridges (Metal-Free) Sedation Dentistry (Oral, IV, Nitrous) Emergency Dental Care Nutritional Counseling Myofunctional Therapy / Referral 3D Cone Beam Imaging (CBCT) Digital Impressions / Intraoral Scanning DNA / Genetic Testing Heavy Metal / Biocompatibility Testing IV Vitamin TherapyWhich of the above are flagship or signature treatments? Comprehensive / New Patient Exams Preventive Cleanings & Hygiene Periodontal Therapy (Scaling & Root Planing) Safe Amalgam (Mercury) Removal (SMART Protocol) BPA-Free / Biocompatible Fillings Ceramic / Zirconia Implants Titanium Implants Full-Mouth Rehabilitation Biomimetic Dentistry Ozone Therapy PRF / PRP Therapy (Platelet-Rich Fibrin) Laser Dentistry Cavitation Surgery / NICO Surgery TMJ / TMD Treatment Airway & Sleep Apnea Treatment Orthodontics / Clear Aligners Pediatric / Children’s Dentistry Cosmetic Dentistry (Veneers, Bonding) Teeth Whitening Root Canal Alternatives Dental Crowns & Bridges (Metal-Free) Sedation Dentistry (Oral, IV, Nitrous) Emergency Dental Care Nutritional Counseling Myofunctional Therapy / Referral 3D Cone Beam Imaging (CBCT) Digital Impressions / Intraoral Scanning DNA / Genetic Testing Heavy Metal / Biocompatibility Testing IV Vitamin TherapySelect any services you consider a primary differentiator or high-value offering.List any additional services not included above.Which 3–5 services generate the most revenue for the practice?Which services do you most want to grow or attract new patients for?Are there any services you plan to add in the next 12 months?Biological / Holistic Approach DetailsTell us about the clinical specifics that substantiate your holistic positioning.What specific protocols does the practice follow for safe amalgam removal (e.g., SMART, IAOMT guidelines)?What biocompatibility testing do you perform or recommend before placing materials?Describe the materials you use and why (e.g., ceramic vs. titanium, BPA-free composites, fluoride-free options).Does the practice integrate with or refer to other health practitioners (naturopaths, functional MDs, chiropractors, nutritionists)? If yes, describe the nature of these relationships.How does the practice approach infection control, air quality, and water purification beyond standard requirements?Does the practice use any specific diagnostic technology that aligns with a biological approach (e.g., 3D imaging, thermography, meridian assessment)?What Makes This Practice UniqueThese are the differentiators that will anchor all your positioning and messaging.If you had 60 seconds to tell a prospective patient why they should choose you over every other dentist in your area, what would you say?What does this practice do that no other practice in your area does?What does the patient experience feel like from the moment they call or walk in? Walk us through a typical first visit.How does the practice approach patient education differently than a conventional office?What technology, equipment, or facility features set the office apart?Is there a treatment outcome, success rate, or case type that the practice is especially known for?What has a patient ever said about the practice that made you think, ‘That’s exactly what we’re about’?Ideal Patients & Audience TypesHelp us define the audiences that marketing should target for the highest ROI.Describe your ideal patient in detail (age range, lifestyle, values, health awareness level, income level).Which niche patient groups does the practice actively serve? (Select all that apply) Health-conscious / wellness-oriented adults Chronically ill patients seeking root-cause dental care Anxious or dental-phobic patients Parents seeking holistic care for children Patients wanting mercury-free / amalgam removal Athletes focused on performance and airway Autoimmune patients Patients dissatisfied with conventional dentistry Patients traveling from out of area or out of state OtherIf you selected ‘Other’ above, please describe.What percentage of your patient base travels more than 30 miles or comes from out of state?What are the top 3 problems or frustrations your ideal patient is experiencing before they find you?What common objections or misconceptions do prospective patients have before booking?Examples: ‘Is biological dentistry legitimate?’, ‘Why is it more expensive?’, ‘Will my insurance cover it?’Why do loyal patients refer friends and family to you? What do they say?What do patients most often praise in reviews, testimonials, or conversations?Geographic Service AreasHelp us map your geographic footprint for local SEO, ad targeting, and content strategy.Primary city / town the practice is located in(Required)List all cities, towns, and neighborhoods you want to target in marketing.County or counties servedBroader region or metro areaDo patients regularly travel from other states to visit your practice? Yes – frequently Occasionally Rarely / neverIf yes, which states do they typically come from?How far (in miles or drive time) is the average patient willing to travel to see you?Are there any areas where you already have a strong presence or reputation?Provider Backgrounds & CredentialsHelp us build authority-driven content from each provider’s training, philosophy, and story.Please complete the following for each provider. Copy and paste this block for additional providers.Provider 1 – Full name & credentialsProvider 1 – Title / roleProvider 1 – Dental school & graduation yearProvider 1 – Advanced certifications (e.g., IAOMT, AAOMP, ABDSM)Provider 1 – Specialties or areas of focusProvider 1 – Years of experienceProvider 1 – Professional membershipsProvider 1 – Personal bio / origin storyProvider 1 – Why they chose biological dentistryProvider 1 – Fun fact or personal interestProvider 2 (leave blank if not applicable)Provider 2 – Full name & credentialsProvider 2 – Title / roleProvider 2 – Dental school & graduation yearProvider 2 – Advanced certificationsProvider 2 – Specialties or areas of focusProvider 2 – Years of experienceProvider 2 – Professional membershipsProvider 2 – Personal bio / origin storyProvider 2 – Why they chose biological dentistryProvider 2 – Fun fact or personal interestAre any of your providers published authors, podcast guests, conference speakers, or recognized thought leaders? Please describe.Patient Experience & Office EnvironmentHelp us capture the sensory and emotional details that differentiate your practice.Describe the look and feel of your office. What would a patient notice the moment they walk in?What amenities or comfort features do you offer? (Select all that apply) Aromatherapy Weighted blankets Noise-canceling headphones Netflix / entertainment during treatment Natural lighting / biophilic design Meditation or calming rooms Complimentary beverages Air purification systems OtherIf you selected ‘Other’ above, please describe.How does the practice manage anxious or phobic patients? What specific steps are taken?What is your average appointment length for a new patient? How does this compare to a typical dental office?How does the practice handle patient communication and follow-up (e.g., pre-visit education, post-treatment check-ins, welcome kits)?Do you provide financial options such as membership plans, payment plans, or insurance alternatives?Competitive DifferentiationHelp us map your competitive landscape so we can position you in whitespace.Who are your top 3–5 competitors (by name and location)?What do these competitors do well that you respect?Where do they fall short compared to your practice?Have you lost patients to a competitor? If so, why do you think they left?What would a patient never experience at your practice that they might at a competitor or conventional office?Reputation, Trust Signals & ProofWhat credibility assets do you have for ads, your website, and social proof?Current Google review count and average star ratingOther review platforms where the practice is active (Yelp, Healthgrades, Facebook, etc.)Do you have patient testimonials available? Yes – written Yes – video Yes – both written and video No, but willing to collectList any awards, recognitions, ‘Best Of’ designations, or media features.List all relevant certifications, accreditations, or affiliations (e.g., IAOMT, SMART Certified, AAOSH, HDA, ADA).Do you have any notable before-and-after case studies or documented patient outcomes?Are there any partnerships, collaborations, or community initiatives that strengthen the practice’s credibility?Brand Voice & MessagingHelp us establish the tone, language, and personality for all your marketing content.Which 3–5 adjectives best describe the personality of the practice?Examples: warm, clinical, rebellious, nurturing, science-driven, empowering, boutique, approachable.How would you describe the tone your brand should convey? (Select all that apply) Professional and authoritative Warm and conversational Educational and empowering Bold and disruptive Calm and reassuring OtherIf you selected ‘Other’ above, please describe.Are there any words, phrases, or claims you want us to always use in marketing?Are there any words, phrases, or claims you want us to never use?Is there a tagline, slogan, or brand promise the practice currently uses?Name 1–3 brands (in any industry) whose marketing style you admire and briefly say why.If the practice were a person at a dinner party, how would it introduce itself?Content & Marketing Assets AvailableHelp us audit what you have so we know what to leverage and what to create.Does the practice currently have a blog? If yes, approximately how many posts?Which social media platforms are active? (Select all that apply) Facebook Instagram YouTube TikTok LinkedIn X / Twitter Pinterest None currentlyDoes the practice have professional photography of the office, team, and/or patients? Yes – recent and high quality Yes – but outdated NoDoes the practice have professional video content? Yes No, but interested NoDo you have existing brand guidelines (logo files, color palette, fonts)?Are there any past marketing campaigns, ads, or landing pages we should review? Please share links or files if available.What marketing efforts have worked well in the past?What marketing efforts have not worked or felt off-brand?Additional InsightsLast step! Anything else that could fuel powerful, authentic marketing.What is the single biggest growth goal for the practice over the next 12 months?If there were one misconception about your practice you could eliminate overnight, what would it be?Is there anything else you want us to know about the practice, the team, the patients, or the vision that hasn’t been covered above?
