check

C.A. & Staff Members:

(Required for all  C.A.'s in the C3 Program, Connected Community or VIP 1:1 Coaching)

Each Chiropractic Assistant &  Team Member must individually Complete this form. If you are the Main D.C., fill out the Main D.C. form to the right instead. 

This quick online form collects general details + goals form you so I can better support your team’s systems, communication & growth.

📌Fill out when you have at least  5 Minutes to truly focus because this MUST be completed in one sitting & does not save your information until you submit.

Click below to begin.

Start

Question 1 of 10

Your Full Name, Role/Title & how long you have worked at your office?

 

Question 2 of 10

What made you apply for the office ( or how did you come to work there) and tell me about what your did prior?

Question 3 of 10

List some of your day to day tasks:

Question 4 of 10

Do you have weekly team meetings and if so what day/time?

Question 5 of 10

List Your Birthday, favorite color, favorite type of sweet dessert (or alternatives if you are not a sweets person) and any food allergies or diet such as Vegan or Gluten free:

 

 

 

Question 6 of 10

If I were to give you a task, which phase below would encourage you more and make you want to get it done?

A

You can do it! (in an encouraging way)

B

You can't do it! (in a teasing way)

Question 7 of 10

What is the biggest goal/target you have from us training together INside the office? As in, what changes would you like to see happen with your team & you get better at? Any frustrations with your team or work? This is a safe place to say anything that is only between us. You can say as little or as much as you would like:

Question 8 of 10

What is the biggest goal/target you have for yourself OUTside of the office? Think personal goals:

Question 9 of 10

Share a time you remember having FUN at the office esp with another team member OR a moment that stood out with a patient, something that brings a smile to your face?

 

Question 10 of 10

Anything else you would like to share or ask me?

 

Confirm and Submit