Complete this application to book your Free Growth Session with Dr Kinnar Shah

This short application helps Dr Kinnar understand your practice and make sure your free Growth Session is as valuable as possible. Takes 2–3 minutes to complete.

Full Name *

Email *

Phone *

Are you a dental practice owner? *

Yes

No

Practice Name

Practice Website

How long have you owned your practice? *

Less than 1 year

1-3 years

3-5 years

5-10 years

10+ years

What stage of growth is your practice at? *

Startup

Growing

Scaling

Exiting

How many chairs does your practice have? *

1-2 chairs

3-5 chairs

6-10 chairs

10+ chairs

What is the size of your active patient base? *

0-250

250-500

500-1,000

1,000-2,500

2,500+

What would you most like to achieve? *

Increase revenue and profitability

Build a high-performance team

Improve case acceptance and conversions

Become a stronger leader and communicate with more authority, clarity, and influence

Better systems, accountability, and consistency across the team

More time and freedom

Select all that apply

What is your biggest challenge right now? *

Team performance and culture

Low case acceptance

Ineffective marketing

Poor follow-up and patient reactivation

Weak leadership

Lack of systems and structure

Communication with patients, team, or associates

Feeling overwhelmed or stuck

Select all that apply

What is the biggest bottleneck in your practice right now — and what is it costing you in growth, profit, team performance, or peace of mind? *

What type of support are you looking for? *

Done with me - I want expert coaching, guidance, and accountability to help me implement faster

Do It Yourself - I’m mainly looking for ideas, resources, and strategies I can implement on my own

How important is it to you to solve this now? (1 = not important, 10 = critical) *

1

2

3

4

5

6

7

8

9

10

How ready are you to take action on growing your practice? *

I'm ready now — I want to move forward as soon as possible

I'm serious about this within the next 3–6 months

I'm still researching my options

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