WISH LIST FORM

IN ORDER FOR US TO BEST SERVE YOUR UNIQUE NEEDS, WE FIND IT BEST TO UNDERSTAND HOW YOU DIFFER FROM THE OVER 5,000 OTHER CHIROPRACTORS THAT WE HAVE SERVED. IN ORDER TO MAKE OUR INITIAL CONSULTATION AS PRODUCTIVE FOR YOU AS POSSIBLE, WE WOULD LIKE TO KNOW A LITTLE MORE ABOUT YOU. EVERY CHIROPRACTOR WE HAVE SERVED HAS A DIFFERENT PHILOSOPHY, DIFFERENT CLINICAL AND BUSINESS STRATEGY AS WELL AS DIFFERENT GOALS AND RESTRICTIONS. THEREFORE, THE MORE I UNDERSTAND WHAT YOUR VISION IS FOR YOUR PRACTICE OF YOUR DREAMS, THE BETTER WE WILL BE ABLE TO ACCURATELY ANSWER ANY QUESTIONS YOU MAY HAVE FOR US. WITH THAT IN MIND, WE HAVE DEVELOPED A “WISH LIST” TO HELP US UNDERSTAND YOU. PLEASE SPEND A FEW MINUTES COMPLETING THE FOLLOWING QUESTIONS:

Whether you are planning to relocate, expand or remodel for efficiency, Davlen Associates, Ltd. can help you, just as we have done for over3,000 other Chiropractors. To best prepare for our upcoming consultation, we must know as much about you and your goals for your practice as possible. Please complete the following questions to the best of your ability. Upon completion, fax this to our office and call us to set up time that is convenient to you. Thank you in advance for allowing us to assist you with improving your Chiropractic office for maximum growth and operating efficiency.

Primary purpose of this change

Please check the items that are important to you during these changes:

Which is more important to you:

Business strategies and systems.

Since our facility design and furnishing systems enhance and support the business strategies or management systems that you follow, please advise us of the following:

Weekly Patient Volume:

Monthly new patients:

Patient Visit Average :

Facility Status


Facility Size

In the practice of your dreams...

Associates

New patient acquisition and Patient Education systems:

Adjustments

Currently

X- Ray


Facility Details

If you haven’t already done so, We can be more accurate answering your questions if we know more about what your facility looks like. The more detailed the sketch the better. If you do not have an original architectural drawing, you can ask any patient with drawing or contracting background, or you can draw one yourself. Either way, Please ensure the following is noted on the drawing:

Overall facility size and shape, Overall facility size and shape, Main entry door, Rear exit door, water (bathrooms , sinks), Structural columns, and Other costly items if moved (X-Ray).

Thank you for taking the time to complete this. We know that our design services and modular furnishing systems can facilitate your practice growth while improving the operating efficiency of your office. This way you should be able to treat more patients, in less space, with fewer staff, making you more profitable

Building solid foundations for successful Chiropractors (631) 924-8686 Fax (704) 664-8070

CONTACT US TODAY!

Davlen has specialized in chiropractic office design since 1987. We have helped over 5,000 chiropractors around the globe. Learn how Davlen can improve your practice!

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