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September 18, 2020

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Please Complete This Quick Application To Reserve Your Free Strategy Session With Patient Rainmaker

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Name*
First Last
Email*
Phone*
Practice Name*
Website*

The #1 Challenge For Growing Your Brand And Practice Right Now Is...*

Your Current MONTHLY Practice Revenue:*
- Not Making Any Money
- $1,000-$5,000
- $5,000-$20,000
- $20,000-$50,000
- $50,000-$100,000
- $100,000+

Do You Have A Business Facebook Page?
- Yes
- No
Link To Facebook Page -

Have You Done Paid Advertising In The Past?
- Yes
- No

What Type(s) Of Paid Advertising Have You Done?
- Google Adwords
- Facebook
- YouTube
- Groupon
- Yelp
- Bing Ads
- Postcards/Newsletters
- Newspaper
- Radio/TV
- Other
Other:

How Much Are You Currently Spending On Advertising Each Month?
- $0
- $1,000-$3,000
- $3,000-$5,000
- $5,000-$10,000
- $10,000-$20,000
- $20,000+

Working With Patient Rainmaker Is By APPLICATION ONLY. Tell Us Why You Think It'd Be Great To Leverage Our Marketing System In Your Practice...*
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