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On-Hold Script Preparation Survey

Your name:
Practice name:
Your address:
City/State/Zip:
Phone:
Fax:
E-mail:
Web Site:

Which package would you like? Please choose one.

2 updates per year and a Holiday program ($39 per month)
4 updates per year and a Holiday program ($59 per month)
6 updates per year and a Holiday program ($79 per month)
Purchase Superpack. (Digital equipment and 4 programs to be used within 3 years) ($975)

What image do you want to project? Choose all that apply.
Professional Staff High End Facilities Family Friendly	Caring New Technology Children Friendly

Office Hours: Please fill-in below.
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:

Doctors Names: Please fill-in below.

What are the primary services/features at your Dental Practice? Choose all that apply.
Cosmetic Dentistry Take-home Whitening In-office Whitening Family Dentistry Childrens Dentistry Orthodontic Implants Cerec Air Abrasian ViziLite Lumineers	Digital X Rays Invisalign Sedation Dentistry Periodontics Endodontics Porcelain Veneers Tooth Colored Fillings Onlays Inlays Crowns Other

What are some of the features or services at your practice that you would like to highlight, and how do they directly benefit your patients? Please fill-in below.

Have you launched any new marketing campaigns?(i.e Limited time specials, promotions, tradeshows, trade associations, etc. Special messages you would like reinforced in you message.) Please fill-in below.

Please list anything at all! (New/updated website, new telephone numbers, new employees, awards, community activities etc. Be creative!) Please fill-in below.

Are there special products or services you offer which your patients may not know about or forgot about? Please fill-in below.

What are some of the questions most frequently asked by your patients? Please fill-in below.

Music type preferred: Please choose one.
Smooth Jazz Classical Easy Listening	Lite Rock Country Pop

Voice talent preferred: Please choose one.
Male Female Both Alternating

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Dentistry On Hold • P.O. Box 723 • 1865 West Wayzata Blvd. • Long Lake, MN 55356
(952) 473-2178 • (800) 811-8282