Please fill out and submit the following questionnaire for your complimentary
Preliminary Demographic and Practice Analysis Report.

Preliminary Demographic & Practice Analysis Report Questionnaire

Name of the location you are considering for cosmetic services

Address

City, State, Zip Code

Your Name

Phone Number

Email Address

Is this part of a medical practice or will it be a free-standing location?

Currently, what type of medical practice is it?

How many active patients are in the practice?

On average, how many patients are seen
in a day?

in a month?

What is your vision for the practice?

Initially, what cosmetic services do you plan to offer (examples: IPL/Laser, microdermabrasion, LED, Botox, other)?

Who do you believe you should be targeting for cosmetic services?

Where do you believe your clientele will come from?

Do you plan on marketing cosmetic services to your current patients?

Who do you believe are your top 3 competitors for cosmetic services, and their locations?

Who will be providing cosmetic services in your practice?

Have you developed a budget for adding/expanding cosmetic services in your practice (by month, by category)?