Audit Intake | Digital Bridge

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To ensure I can provide a comprehensive audit, please complete this form at least 24 hours before our scheduled session. This gives me time to review your practice data.

1. Practice Information

*Practice name

*Doctor's name

*Contact person / role

*Phone

*Email

*Date

Location

*Company Website

2. Practice Overview

*Specialties

*Number of providers

*Total Number of Clinical Staff

*Case mix (approximate % breakdown)

3. Lab / Production Info

*Average # of cases per week

Just a rough estimate of combined total lab cases.

*Primary Impression method:

Traditional Alginate/PVS

Digital Scan

Both

*Any In-house lab work being done?

Yes

No

Labs you send your cases to

*If Yes, Please list

*Equipment/Software currently using

Please list equipment and the brand the office currently uses.

*How often is your current technology being used?

Daily

A few times a week

Occasionally

Rarely / not currently in use

4. Goals / Pain Points

*My biggest priority right now

Reducing Lab Fees

Faster Case Turnaround

Training Staff

Integrating New Tech/ ROI

Just want more information

Other

*What's your single biggest pain point or challenge right now?

*What challenges are you hoping to address and what are your goals for your practice?

5. Additional Notes / Expectations

Any additional information?

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