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PLEASE READ BEFORE STARTING YOUR APPLICATION:

This application is designed to determine if Free + Easy Doctor is a good fit for you. Only fill this out if you are READY to commit to radical action, serious transformation, and complete ownership of your results. If you're less than an 8 out of 10 serious about changing your practice and your life, this isn't the time to apply.

I read each of these applications personally. So please be as detailed as possible.

BASIC INFORMATION

First Name

Last Name

Website

WHERE YOU ARE

How long have you been in practice, and what does your patient load look like right now?

How would you describe where your business is right now?

What does your revenue look like right now? A rough range is fine.

WHAT IS NOT WORKING

What is the biggest thing that feels stuck or off right now? Be as specific as you can.

What have you already tried to address this? This could be coaching, courses, books, practice changes, etc.

Why do you think those things have not worked?

WHAT YOU WANT

What does your practice look like a year from now, if everything goes right? Be specific.

What does your life look like in the next 12 months if nothing changes? Be specific.

READINESS

What made you reach out right now, rather than six months ago?

My coaching goes deep. We’ll do rigorous thought work and mind management. That means examining your stories, testing your “facts,” and getting comfortable with discomfort. Are you all-in on doing this work for yourself? Why or why not?

Anything else I should know (schedule constraints, programs you're considering, etc...?)

Submit

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