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Clinic Screening Process

* Required Information

Contact Information

* Practice Name:
*

Contact Person:

  Title:
  Address 1:
  Address 2:
  City:
  State:
  Zip Code:
  Phone Number: (999-999-9999)
  Fax Number: (999-999-9999)
  Mobile Phone: (999-999-9999)
* E-mail:
  Website:

About Your Clinic

When was the practice established? (MM/DD/YYYY)
Please briefly describe your practice.
Practice Specialties:

General Med
Pocket Pets
Reptiles
Small Animal
Emergency
Homeopathic
Large Animal
Shelter Med
Avian
Lab/Research
Specialty
Other

Hours of Operation:
Person in charge of hiring:
Number of Doctors (Including full time equivalents)

Doctor's Name:
If your practice has multiple doctors, we will contact you for further information.

College of Graduation:
Years of experience:
Community Involvement:
Number of Manager(s):
Number of Lead Technician(s):
Number of Technician(s):
Doctor to Tech Ratio:
Approximate Tech turnover rate this past year: None 10% 25% 50% 75% 90% 100%
Number of Client Service Representatives:
Describe the market segment you serve:
Do you have a uniform policy? Yes No
If yes, please list requirements:
What is the Average Client Transaction (ACT) for your practice? ($9999)
What is the revenue per staff hour worked? ($9999)
What is Cost of Goods Sold? ($9999)
What percent of gross income comes from Dentistry? None 10% 25% 50% 75% 90% 100%
What percent of gross income comes from Nutritional sales? None 10% 25% 50% 75% 90% 100%
Do you offer boarding and/or grooming services? Yes No
Do you hold staff meetings? If so, how often? Yes No
What is your practice’s net profit before veterinarian compensation? ($9999)
How did you hear about MyVeterinaryCareer.com? Newspaper
Online Search Enginer
Trade Publication
Referral
Other