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For the Main D.C.:

(This form is for the Head D.C. only. Required for all  D.C's that have enrolled their team in the C3 Program, Connected Community or VIP 1:1 Coaching)


Completing this helps me understand you, your leadership style, and goals so I can best support your Chiropractic Assistant and your office 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.

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Question 1 of 20

BEFORE WE BEGIN...

I want to challenge you to approach this assessment believing that anything really is possible for your practice and your team.

 

Go deep. Speak from the heart. Don’t give me the answer you think you should give me ... tell me what you actually want.

 

This is a safe space to be honest about what’s working, what isn’t, what you’re frustrated by, and what you would LOVE to see become possible.

 

I’m not only here to develop your Chiropractic Assistant. I’m here to support you as the leader, understand the vision you have for your practice, and help your team become stronger in the areas that will support that vision.

 

So as you answer these questions, go beyond surface level. Get specific. Dream bigger than what feels realistic right now. Let me see what you really want.

 

One important thing before you begin ... please make sure you have at least 10 uninterrupted minutes to fully focus and complete this assessment.

 

Your answers will not save if you exit before submitting, and I want you to have the space to give this the thought it deserves.

 

Ready? Let’s GO. 🔥

(Select all that apply)
A

❤️‍🔥YES ... I have at least 10 minutes, I’m ready to fully focus, and I’m ALL IN on seeing what’s possible.

Question 2 of 20

What is your full name, and what do you prefer I call you?

Question 3 of 20

Tell me about YOUR WHY and your personal Chiropractic story. What made you want to become a Chiropractor, and how long have you been practicing?

Question 4 of 20

When is your Birthday:

 

 

 

Question 5 of 20

Your Favorite color:

 

Question 6 of 20

Favorite type of sweet food & any food allergies or diet restrictions (ex: Vegan, Nut allergy, Gluten free etc)? :

 

Question 7 of 20

What is your 2026 collection goal? Do your Chiropractic Assistants know this number? If not, what has kept you from sharing it with them?

Question 8 of 20

What are your current monthly practice goals? (Collections, PVs, NPs, referrals, etc.) Do these targets stay consistent or change month to month? And most importantly ... does your TEAM know what you’re working toward together?

Question 9 of 20

Do your Chiropractic Assistants currently see the overall monthly office collection numbers? 

A

Yes - they all do.

B

Only Certain Members of my staff see them.

C

No - they do not look them up or have access.

Question 10 of 20

If they do see them & you asked them tomorrow where we are at month to date, would they be able to say instantly or have to look them up?

A

They all would definitely have a rough idea of where we are at.

B

Half & Half - some of my C.A.'s would know but not all of them.

C

They would have to look them up.

D

N/A - I do not share the overall office collection numbers with them.

Question 11 of 20

Be as exact as you can here ... what has been your highest DAY of collections so far, and what has been your highest MONTH of collections to date?

Question 12 of 20

 Do your Chiropractic Assistants currently have a bonus or incentive structure in place? If yes, tell me how it works and what it is based on.

Question 13 of 20

What is the biggest goal or target you have for YOURSELF outside of the office? Think personal here ... what are you working toward that matters to you?

Question 14 of 20

What is EACH team member already AWESOME at? Tell me their name and what you see as their greatest strengths.

Question 15 of 20

Where do you see the biggest opportunity for growth in EACH team member? Be specific ... confidence, communication, leadership, collections, referrals, follow-up, patient connection, organization, etc.

 

Question 16 of 20

What does your employee review and development process currently look like? Especially for new hires ... do you have a structured process in place for feedback, goals, reviews, and continued growth?

Question 17 of 20

When you think about the next level of your practice, what currently feels like it relies too heavily on YOU?

Question 18 of 20

Share a time you remember having FUN in the office with your team OR a moment with a patient that still brings a smile to your face. What happened?

 

Question 19 of 20

 Anything else you would like me to know about you, your team, your practice, or what you want from our time together? This is your space ... tell me anything you think would help me coach and support you better.

 

Question 20 of 20

FINAL QUESTION ... If we could create ONE powerful shift in your Chiropractic Assistant or your practice through our work together, what would make you walk away thinking, “THIS was absolutely worth the investment”?

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