MegaGen Practice
Catalyst Program
Complete the form below and
schedule a free practice growth consultation.
Click to Schedule Your Free Consultation Today!
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Doctor's Name
*
First
Last
Legal Practice Name i.e. LLC, PLLC, Inc.
*
Doctor's Email
*
Doctor's Cell
*
United States +1
United States
+1
United Kingdom
+44
Afghanistan
+93
Albania
+355
Algeria
+213
American Samoa
+1
Andorra
+376
Angola
+244
Anguilla
+1
Antigua & Barbuda
+1
Argentina
+54
Armenia
+374
Aruba
+297
Ascension Island
+247
Australia
+61
Austria
+43
Azerbaijan
+994
Bahamas
+1
Bahrain
+973
Bangladesh
+880
Barbados
+1
Belarus
+375
Belgium
+32
Belize
+501
Benin
+229
Bermuda
+1
Bhutan
+975
Bolivia
+591
Bosnia & Herzegovina
+387
Botswana
+267
Brazil
+55
British Indian Ocean Territory
+246
British Virgin Islands
+1
Brunei
+673
Bulgaria
+359
Burkina Faso
+226
Burundi
+257
Cambodia
+855
Cameroon
+237
Canada
+1
Cape Verde
+238
Caribbean Netherlands
+599
Cayman Islands
+1
Central African Republic
+236
Chad
+235
Chile
+56
China
+86
Christmas Island
+61
Cocos (Keeling) Islands
+61
Colombia
+57
Comoros
+269
Congo - Brazzaville
+242
Congo - Kinshasa
+243
Cook Islands
+682
Costa Rica
+506
Croatia
+385
Cuba
+53
Curaçao
+599
Cyprus
+357
Czechia
+420
Côte d’Ivoire
+225
Denmark
+45
Djibouti
+253
Dominica
+1
Dominican Republic
+1
Ecuador
+593
Egypt
+20
El Salvador
+503
Equatorial Guinea
+240
Eritrea
+291
Estonia
+372
Eswatini
+268
Ethiopia
+251
Falkland Islands
+500
Faroe Islands
+298
Fiji
+679
Finland
+358
France
+33
French Guiana
+594
French Polynesia
+689
Gabon
+241
Gambia
+220
Georgia
+995
Germany
+49
Ghana
+233
Gibraltar
+350
Greece
+30
Greenland
+299
Grenada
+1
Guadeloupe
+590
Guam
+1
Guatemala
+502
Guernsey
+44
Guinea
+224
Guinea-Bissau
+245
Guyana
+592
Haiti
+509
Honduras
+504
Hong Kong SAR China
+852
Hungary
+36
Iceland
+354
India
+91
Indonesia
+62
Iran
+98
Iraq
+964
Ireland
+353
Isle of Man
+44
Israel
+972
Italy
+39
Jamaica
+1
Japan
+81
Jersey
+44
Jordan
+962
Kazakhstan
+7
Kenya
+254
Kiribati
+686
Kosovo
+383
Kuwait
+965
Kyrgyzstan
+996
Laos
+856
Latvia
+371
Lebanon
+961
Lesotho
+266
Liberia
+231
Libya
+218
Liechtenstein
+423
Lithuania
+370
Luxembourg
+352
Macao SAR China
+853
Madagascar
+261
Malawi
+265
Malaysia
+60
Maldives
+960
Mali
+223
Malta
+356
Marshall Islands
+692
Martinique
+596
Mauritania
+222
Mauritius
+230
Mayotte
+262
Mexico
+52
Micronesia
+691
Moldova
+373
Monaco
+377
Mongolia
+976
Montenegro
+382
Montserrat
+1
Morocco
+212
Mozambique
+258
Myanmar (Burma)
+95
Namibia
+264
Nauru
+674
Nepal
+977
Netherlands
+31
New Caledonia
+687
New Zealand
+64
Nicaragua
+505
Niger
+227
Nigeria
+234
Niue
+683
Norfolk Island
+672
North Korea
+850
North Macedonia
+389
Northern Mariana Islands
+1
Norway
+47
Oman
+968
Pakistan
+92
Palau
+680
Palestinian Territories
+970
Panama
+507
Papua New Guinea
+675
Paraguay
+595
Peru
+51
Philippines
+63
Poland
+48
Portugal
+351
Puerto Rico
+1
Qatar
+974
Romania
+40
Russia
+7
Rwanda
+250
Réunion
+262
Samoa
+685
San Marino
+378
Saudi Arabia
+966
Senegal
+221
Serbia
+381
Seychelles
+248
Sierra Leone
+232
Singapore
+65
Sint Maarten
+1
Slovakia
+421
Slovenia
+386
Solomon Islands
+677
Somalia
+252
South Africa
+27
South Korea
+82
South Sudan
+211
Spain
+34
Sri Lanka
+94
St. Barthélemy
+590
St. Helena
+290
St. Kitts & Nevis
+1
St. Lucia
+1
St. Martin
+590
St. Pierre & Miquelon
+508
St. Vincent & Grenadines
+1
Sudan
+249
Suriname
+597
Svalbard & Jan Mayen
+47
Sweden
+46
Switzerland
+41
Syria
+963
São Tomé & Príncipe
+239
Taiwan
+886
Tajikistan
+992
Tanzania
+255
Thailand
+66
Timor-Leste
+670
Togo
+228
Tokelau
+690
Tonga
+676
Trinidad & Tobago
+1
Tunisia
+216
Turkey
+90
Turkmenistan
+993
Turks & Caicos Islands
+1
Tuvalu
+688
U.S. Virgin Islands
+1
Uganda
+256
Ukraine
+380
United Arab Emirates
+971
United Kingdom
+44
United States
+1
Uruguay
+598
Uzbekistan
+998
Vanuatu
+678
Vatican City
+39
Venezuela
+58
Vietnam
+84
Wallis & Futuna
+681
Western Sahara
+212
Yemen
+967
Zambia
+260
Zimbabwe
+263
Åland Islands
+358
Office Phone
*
United States +1
United States
+1
United Kingdom
+44
Afghanistan
+93
Albania
+355
Algeria
+213
American Samoa
+1
Andorra
+376
Angola
+244
Anguilla
+1
Antigua & Barbuda
+1
Argentina
+54
Armenia
+374
Aruba
+297
Ascension Island
+247
Australia
+61
Austria
+43
Azerbaijan
+994
Bahamas
+1
Bahrain
+973
Bangladesh
+880
Barbados
+1
Belarus
+375
Belgium
+32
Belize
+501
Benin
+229
Bermuda
+1
Bhutan
+975
Bolivia
+591
Bosnia & Herzegovina
+387
Botswana
+267
Brazil
+55
British Indian Ocean Territory
+246
British Virgin Islands
+1
Brunei
+673
Bulgaria
+359
Burkina Faso
+226
Burundi
+257
Cambodia
+855
Cameroon
+237
Canada
+1
Cape Verde
+238
Caribbean Netherlands
+599
Cayman Islands
+1
Central African Republic
+236
Chad
+235
Chile
+56
China
+86
Christmas Island
+61
Cocos (Keeling) Islands
+61
Colombia
+57
Comoros
+269
Congo - Brazzaville
+242
Congo - Kinshasa
+243
Cook Islands
+682
Costa Rica
+506
Croatia
+385
Cuba
+53
Curaçao
+599
Cyprus
+357
Czechia
+420
Côte d’Ivoire
+225
Denmark
+45
Djibouti
+253
Dominica
+1
Dominican Republic
+1
Ecuador
+593
Egypt
+20
El Salvador
+503
Equatorial Guinea
+240
Eritrea
+291
Estonia
+372
Eswatini
+268
Ethiopia
+251
Falkland Islands
+500
Faroe Islands
+298
Fiji
+679
Finland
+358
France
+33
French Guiana
+594
French Polynesia
+689
Gabon
+241
Gambia
+220
Georgia
+995
Germany
+49
Ghana
+233
Gibraltar
+350
Greece
+30
Greenland
+299
Grenada
+1
Guadeloupe
+590
Guam
+1
Guatemala
+502
Guernsey
+44
Guinea
+224
Guinea-Bissau
+245
Guyana
+592
Haiti
+509
Honduras
+504
Hong Kong SAR China
+852
Hungary
+36
Iceland
+354
India
+91
Indonesia
+62
Iran
+98
Iraq
+964
Ireland
+353
Isle of Man
+44
Israel
+972
Italy
+39
Jamaica
+1
Japan
+81
Jersey
+44
Jordan
+962
Kazakhstan
+7
Kenya
+254
Kiribati
+686
Kosovo
+383
Kuwait
+965
Kyrgyzstan
+996
Laos
+856
Latvia
+371
Lebanon
+961
Lesotho
+266
Liberia
+231
Libya
+218
Liechtenstein
+423
Lithuania
+370
Luxembourg
+352
Macao SAR China
+853
Madagascar
+261
Malawi
+265
Malaysia
+60
Maldives
+960
Mali
+223
Malta
+356
Marshall Islands
+692
Martinique
+596
Mauritania
+222
Mauritius
+230
Mayotte
+262
Mexico
+52
Micronesia
+691
Moldova
+373
Monaco
+377
Mongolia
+976
Montenegro
+382
Montserrat
+1
Morocco
+212
Mozambique
+258
Myanmar (Burma)
+95
Namibia
+264
Nauru
+674
Nepal
+977
Netherlands
+31
New Caledonia
+687
New Zealand
+64
Nicaragua
+505
Niger
+227
Nigeria
+234
Niue
+683
Norfolk Island
+672
North Korea
+850
North Macedonia
+389
Northern Mariana Islands
+1
Norway
+47
Oman
+968
Pakistan
+92
Palau
+680
Palestinian Territories
+970
Panama
+507
Papua New Guinea
+675
Paraguay
+595
Peru
+51
Philippines
+63
Poland
+48
Portugal
+351
Puerto Rico
+1
Qatar
+974
Romania
+40
Russia
+7
Rwanda
+250
Réunion
+262
Samoa
+685
San Marino
+378
Saudi Arabia
+966
Senegal
+221
Serbia
+381
Seychelles
+248
Sierra Leone
+232
Singapore
+65
Sint Maarten
+1
Slovakia
+421
Slovenia
+386
Solomon Islands
+677
Somalia
+252
South Africa
+27
South Korea
+82
South Sudan
+211
Spain
+34
Sri Lanka
+94
St. Barthélemy
+590
St. Helena
+290
St. Kitts & Nevis
+1
St. Lucia
+1
St. Martin
+590
St. Pierre & Miquelon
+508
St. Vincent & Grenadines
+1
Sudan
+249
Suriname
+597
Svalbard & Jan Mayen
+47
Sweden
+46
Switzerland
+41
Syria
+963
São Tomé & Príncipe
+239
Taiwan
+886
Tajikistan
+992
Tanzania
+255
Thailand
+66
Timor-Leste
+670
Togo
+228
Tokelau
+690
Tonga
+676
Trinidad & Tobago
+1
Tunisia
+216
Turkey
+90
Turkmenistan
+993
Turks & Caicos Islands
+1
Tuvalu
+688
U.S. Virgin Islands
+1
Uganda
+256
Ukraine
+380
United Arab Emirates
+971
United Kingdom
+44
United States
+1
Uruguay
+598
Uzbekistan
+998
Vanuatu
+678
Vatican City
+39
Venezuela
+58
Vietnam
+84
Wallis & Futuna
+681
Western Sahara
+212
Yemen
+967
Zambia
+260
Zimbabwe
+263
Åland Islands
+358
Practice Address
*
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Your address is needed to analyze detailed demographics in your market. Much of our success is based on knowing the key demographic factors to success. If it isn't a good fit we're happy to part as friends!
Specialty
*
Select One
General Dentist
Implantologist
Oral Surgeon
Periodontist
Prosthodontist
Gross Practice Revenue
*
Select One
150,000 - 300,000
301,000 - 500,000
501,000 - 1,000,000
1,000,001 - 2,000,000
2,000,001 - 4,000,000
4,000,001 - 5,000,000
5,000,001 or more
Please list the top three greatest obstacles you’d like to overcome?
*
It can be anything
What is the most effective and least effective marketing campaigns you’ve had?
*
If you have not done any marketing please answer NA
Do you currently advertise your practice?
*
Select One
YES
NO
I did but stopped advertising
What is your monthly advertising budget?
*
Select One
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
$10,000
$11,000
$12,000
$13,000
$14,000
$15,000
$16,000
$17,000
$18,000
$19,000
$20,000 or more
Do you have someone managing your SEO?
*
Select One
YES
NO
How do you currently handle your inbound after hours calls?
*
Select One
Dedicated employee
3rd party call center
Calls go to voicemail
Select the % of growth positive or negative that you had last year
*
Select One
+1%
-1%
+2%
-2%
+3%
-3%
+4%
-4%
+5%
-5%
+6%
-6%
+7%
-7%
+8%
-8%
+9%
-9%
+10%
-10%
+11%
-11%
+12%
-12%
+13%
-13%
+14%
-14%
+15%
-15%
+16%
-16%
+17%
-17%
+18%
-18%
+19%
-19%
+20% or more
-20% or more
What is your case acceptance rate for dental implants?
*
Select One
I don't track case acceptance
+5%
+6%
+7%
+8%
+9%
+10%
+11%
+12%
+13%
+14%
+15%
+16%
+17%
+18%
+19%
+20%
+21%
+22%
+23%
+24%
+25%
+26%
+27%
+28%
+29%
+30%
+31%
+32%
+33%
+34%
+35%
+36%
+37%
+38%
+39%
+40% or more
Do you keep a list of patients who didn’t accept treatment?
*
Yes
No
Who manages your lead nurturing?
*
Select One
We don't have a lead nurturing program
I have a dedicated internal marketing person doing it.
I have a 3rd party provider doing lead nurturing for us
My CRM automatically does nurturing
Do you track and record inbound calls?
*
Yes
No
How many 1 & 2-star Google reviews do you have?
*
Select One
I don't have any google reviews
1
2
3
4
5
6
7
8
9
10
11 to 15
16 to 20
21 to 25
26 to 30
31 to 35
36 or more
Do you offer team incentives for growth?
*
Yes
No
Thinking about it
Do you track patient referral sources (e.g., google, facbook, tv etc.?
*
Yes
No
Thinking about it
Do you have an online scheduling on your website?
*
Yes
No
Thinking about it
Are you happy with your current website
*
Yes
No
Thinking of changing
Do you have video testimonials on your website?
*
Yes
No
Thinking of adding videos
Do you have a Google+ or Google Business page? (copy)
*
Yes
No
Not sure
Are you running a social media campaign?
*
Yes
No
No, but I am interested
Do you both place and restore implants yourself?
*
Yes
No
How many years have you been placing implants?
*
Select One
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20 or more
Types of implants you place?
*
MegaGen
Nobel
Straumann
Neodent
Implant Direct
Biohorizon
Astra
SIN
Zimmer
Do you need any additional equipment or training to offer IV sedation?
*
Yes
No
If you answered no to having a CBCT do you have room for one?
*
Yes
No
Already have a CBCT
If you already have a CBCT please tell us the brand, model and age of the system. If you don't have a CBCT answer NA
*
How many dental chairs do you have?
*
Select One
1
2
3
4
5
6
7
8
9
10
11
12
14
14
15 or more
Who does your advertising?
*
Select One
Internal team
External team
I do it myself
What specifically are you trying to promote?
*
i.e. implants, full-arch cases, Invisalign, teeth whitening etc.
How do you currently handle your inbound calls during office hours?
*
Select One
Front desk answers calls
Dedicated employee
3rd party call center
How did your practice perform last year?
*
Select One
We were down
We were flat
We were up
What is your growth goal this year?
*
Select One
+1%
+2%
+3%
+4%
+5%
+6%
+7%
+8%
+9%
+10%
+11%
+12%
+13%
+14%
+15%
+16%
+17%
+18%
+19%
+20% or more
What is your case acceptance rate for full-arch cases?
*
Select One
I don't track case acceptance
+5%
+6%
+7%
+8%
+9%
+10%
+11%
+12%
+13%
+14%
+15%
+16%
+17%
+18%
+19%
+20%
+21%
+22%
+23%
+24%
+25%
+26%
+27%
+28%
+29%
+30%
+31%
+32%
+33%
+34%
+35%
+36%
+37%
+38%
+39%
+40% or more
Do you have a lead nurturing program?
*
Yes
No
Not sure
What is the name and version of your practice management software?
*
Select One
Dentrix
Eaglesoft
Open Dental
Carestream Dental
SoftDent
PracticeWorks
Curve Dental
DentiMax
Ortho2
Fuse by Patterson
Ace Dental
Other
We continually update our integration capabilities to support newer or emerging systems. If you have a specific PMS that isn’t listed, we can explore custom integrations or provide guidance on compatibility.
How many 5-star Google reviews do you have?
*
Select One
I don't have any google reviews
1 to 5
6 to 10
11 to 15
16 to 20
21 to 25
26 to 30
31 to 35
36 to 40
41 to 45
46 to 50
51 to 100
101 to 150
151 to 200
201 to 250
251 to 300
301 to 350
351 to 400
401 to 450
451 to 500
501 or more
Are your local directories accurate (Google, Yelp, etc.)?
*
Yes
No
Not sure
Have you provided communication or telephone training to your team?
*
Yes
No
Thinking about it
Do you have an online chat bot on your website?
*
Yes
No
Thinking about it
Is your website mobile-ready?
*
Yes
No
Not sure
Do you have a Google+ or Google Business page?
*
Yes
No
Not sure
Do you have a patient appointment reminder service?
*
Yes
No
No, but I am interested
Would you be interested in a secret shopper and call training program?
*
Yes
No
Maybe would like to learn more
Would you like to improve your website conversion rates?
*
Yes
No
Maybe would like to learn more
Number of implants you place annually?
*
Select One
1 to 25
26 to 50
51 to 100
101 to 150
151 to 200
201 to 300
301 or more
How many years have you been restoring implants?
*
Click on the Dropdown
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20 or more
Check each of the procedures you offer
*
Dentures
Overdentures
All-On-X
Is your practice equipped to offer IV sedation?
*
Yes
No
Do you have an onsite working CBCT?
*
Yes
No
If you answered yes to having room for a CBCT would you be willing to invest in one to participate in the Renew Affiliate program
*
Yes
No
Maybe need to know more
Already have a CBCT
Approximately how many square feet is your practice?
*
How many surgical suites do you have?
*
Select One
1
2
3
4
5
6
7
8
9
10
11
12
14
14
15 or more
How many locations do you have?
*
Select One
1
2
3
4
5
6
7
8
9
10
11
12
14
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50 or more
Continue