Hygiene Diamonds.com

Practice Survey

Average Daily production for DR
Average Daily production for HYG
Average monthly collections
Average number of new patients per month
Do you have a referral program?		Yes No
Are you currently running any "new patient offers"? If so, what are they?

Are you currently tracking where your new patients are coming from?		Yes No
Do you have a continuing care program?		Yes No
Are all Hygiene patients pre-scheduled for their appointments?		Yes No
Do you have a policy for failed appointments?		Yes No
What is your process for confirming these appointments?

What products do you currently recommend for your patients?

Do you retail any hygiene products out of your practice?		Yes No
Are you currently using any Chemotherapeutics in your Periodontal program? (Atridox, Arestin, etc.)		Yes No
If yes, what are they?

Do you have a soft tissue laser in your practice?		Yes No
What are your goals for your hygiene department? (list several)

Practice or Doctor name
Email (Required)

Note: This email address will only be used as a return address for us to respond to your survey. It will not be stored on any of our servers or sold to anyone.