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* 1. Name & Email:

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* 2. Tell me a little about your business: location(s), team, revenues, what’s going well, and where are you stuck?

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* 3. What are your goals for your business – revenues, growth, exit, treating or not?

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* 4. How close are you to those goals?

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* 5. Be 100% Honest – What Do You Think Is Stopping You From Achieving your Goals?

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* 6. How many hours per week are you working on your business doing strategic planning, systematizing processes, training staff, etc. (this does not include paying bills, cleaning, ordering supplies, marketing, etc.)?

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* 7. How many hours per week are you treating patients?

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* 8. If you're accepted to the PT Millionaire's Mastermind are you willing to commit 2-4 hours per month for the next 12-18 months with the group?

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* 9. How interested are you in getting some support to achieve your goals faster? 0 - 10

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* 10. If You Are ACCEPTED, How Soon Can You Get Started?

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