Join A Focus Group!
Apply now for a Focus Group (AKA Mastermind Group) -  This group is specifically for small group practice owners that are also insurance based.  The monthly cost is $249 a month for 6 months.  Once you submit your application we will review it and be in touch with you in a day or 2.  Thanks for your application!
Sign in to Google to save your progress. Learn more
Name *
Email Address *
Cell Number *
Your Website or Facebook Page
Do you currently have a group practice? *
How long have you been in practice? *
Required
How many clinicians do you have in your practice? *
Current average monthly practice income?
What is your goal income; where would you like to be?
What is unique about your practice or niche?
Why are you interested in joining a Focus Group?
What would you like the most help with? What are your goals for being in the Focus Group?
What do you see as the current barriers for you in reaching your goals? (be honest)
What are your business goals?
Who referred you to me and how did you learn about The Practice of Therapy?
What questions do YOU have?
I understand that by joining the focus group I am committing to regular attendance, confidentiality about what is discussed, and participation outside the group meetings.  I also understand the financial commitment and agree to the terms of this agreement. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kingsport Counseling Associates, PLLC. Report Abuse