Discovery Questionnaire
We appreciate your interest in Kare Mobile - the leader in supporting comprehensive, concierge, mobile dental practices! Mobile dentistry is exciting for many reasons, but particularly because it enables dentists and hygienists to practice on their own terms. There are many to pursue mobile dentistry, so please spend a few minutes helping us understand your dream. Your answers will ensure that we tailor our discussions and materials to fit your use case. Thanks again for your interest and your valuable time!
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
Which type of provider are you? *
Years of experience as a provider? *
Do you currently own a practice? *
What zipcode will be your primary target area? *
Who will be your primary target audience? *
Required
How long is too long to drive between patients? *
What days will your mobile clinic serve patients? *
Required
How many hours per day will your mobile clinic serve patients? *
What are your long-term goals for mobile dentistry? *
What is most important to you about mobile dentistry? *
Please select your top 3 reasons.
Required
Ideally, when would you like to launch your mobile dental practice? *
MM
/
DD
/
YYYY
What sparked your interest in mobile dentistry? *
What do you foresee for your mobile dental practice in 5 years? *
Please describe your first entrepreneurial endeavor, why you pursued that particular endeavor, how old you were at the time, and what you learned from it. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Kare Mobile Inc.. Report Abuse