Coaching Questionnaire

Let’s Get to Know Each Other!

Please take a moment to fill out a questionnaire so I can fully understand your goals and situation. Together we’ll design an affordable coaching plan that works for you.

Let’s Get Started…

Please take a moment to fill out this questionnaire so we can design a coaching package that meets your needs and budget.

Name*
First Last
Phone*
Email*
Website
How long have you been in practice?*
- Less than a year
- 1 to 5 years
- 6-10 years
- Over 10 years
What are your top three goals you want to accomplish in your career?*
What’s your time frame to accomplish these goals?*
- Less than 6 months
- 6 months to 1 year
- 1-3 years
- 3- 5 years
What is unique about your services or niche?*
Please list several examples of practice websites that appeal to you as to what your practice might look someday.*
If you currently don’t own a private practice, tell me about your day job and why you want a change.*
How confident are you in your marketing ability?*
- 5-Absolutely confident
- 4-Confident
- 4-Somewhat Confident
- 2-Unconfident
- 1-Not at all confident
How would you rate your confidence in creating business systems like scheduling, onboarding, accounting, documentation etc.?*
- 5-Absolutely confident
- 4-Confident
- 4-Somewhat Confident
- 2-Unconfident
- 1-Not at all confident
How did you hear about me?*
What’s your approximate budget?
I know this question might seem awkward, but having a number helps me to design an affordable proposal that’s a good fit for both of us. If you don’t know at this moment or feel uncomfortable in sharing, feel free to leave it blank.
Is there anything else you want me to know?

About Paul

I’m Paul Potter. I’m here to show you how to create a fulfilling and profitable practice.

I have been in the physical therapy field for nearly 40 years, owning my own practice and caring for patients from all walks of life. I have seen first-hand how the care therapists provide can make a positive impact on patients lives.

Learn More

Contact

Get in touch with me today to discuss how we can best serve you and your practice!

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