Combined Form - Breakaway Seminars

1 Event Date

2 Enter Information

3 Practice Health

4 Payment

Choose Seminars
Seminars
Choose Preferred Date
Advanced Practice Acquisition
Dates*
Advanced Startup
Dates*
Business Masters
Dates*
Includes FREE admission to the Dental Whale Business Immersion Summit at Aria Resort, Las Vegas
*All registrants must stay at the Aria Resort & Casino*
Business Masters at Business Immersion Summit
Each Dentist Owner registration includes exclusive access to this Breakaway online course.
Dates*
Group Practice Ownership
Dates*
New Dentist Bootcamp
Dates*
Office Manager Mastery
Dates*
Practice Acquisition
Dates*
Transformation Retreat
Dates*
Select Number of Seats for Advanced Practice Acquisition
Live Event + Online Access BUNDLE
Bundle includes a FREE seat at the Live Event plus the Online Orca Course. Online access is unlimited for 12 months.
X $1,999.00
Dentist/Exec/Residence
Live Streaming Event Online
X $1,495.00
Dentist/Exec/Residence
Online-Only
Upon course release, the ONLINE-ONLY option includes 12 months of unlimited access.
X $1,495.00
Dentist/Exec/Residence
Select Number of Seats for Advanced Startup
Dentist/Exec
Includes $50 off your first month with our partners at Front Office Rocks! Subject to Verification and Approval.
X $1,999.00
dentist
Dentist/Exec/Resident
Dentist/Exec - ONLINE ONLY
ONLINE-ONLY (12-month unlimited access) Access granted within 24 hours of registration.
X $1,199.00
dentist
Dentist/Exec/Resident
Staff/Spouse
ONLY registered Advanced Startup Dentists qualify to enroll staff at this rate. Subject to Verification and Approval.
X $999.00
Staff*
STAFF/SPOUSE/ASU RETURN ATTENDEE
Dental Student
Subject to Verification and Approval.
X $999.00
Dental
DENTAL STUDENTS
Quantity*
Select Number of Seats for Business Masters
Dentist/Exec/Resident
Includes $50 off your first month with our partners at Front Office Rocks! Subject to Verification and Approval.
X $2,998.00
dentist
Dentist/Exec/Residence
dentist
Dentist/Exec/Residence
Staff/Spouse
ONLY registered Business Masters Dentists qualify to enroll staff at this rate. Subject to Verification and Approval.
X $1,199.00
Dentist/Exec/Residence
Dentist/Exec/Residence
Select Number of Seats for Business Masters in Las Vegas
Location: Aria Resort & Casino
Dentist/Exec/Resident*
Subject to Verification and Approval. Price includes admission to Business Immersion Summit 2020. Includes Breakaway On-Demand.
X $2,860.00
dentist
Dentist/Exec/Residence
Staff/Spouse
Subject to Verification and Approval. Price includes admission to Business Immersion Summit 2020. Registration for a Breakaway Seminar entitles your practice to free access to all Front Office Rocks virtual events upon member activation.
X $1,380.00
Dentist/Exec/Residence
Select Number of Seats for Group Practice Ownership
General Admission*
Subject to Availability. Includes $50 off your first month with our partners at Front Office Rocks!
X $2,310.00
dentist
Dentist/Exec/Residence
Select Number of Seats for New Dentist Bootcamp
General Admission*
Subject to Availability.
X $1,195.00
dentist
Dentist/Exec/Residence
Select Number of Seats for Office Manager Mastery
General Admission*
Dentist Owner must have previously attended the Business Masters Seminar. Subject to Verification & Approval.
X $1,380.00
dentist
Dentist/Exec/Residence
Select Number of Seats for Practice Acquisition
General Admission*
Subject to Verification and Approval. Includes $50 off your first month with our partners at Front Office Rocks!
X $1.00
dentist
Dentist/Exec/Residence
Select Number of Seats for Transformation Retreat
Dentist/Exec/Owner*
Subject to Verification and Approval.
X $3,995.00
dentist
Dentist/Exec/Residence
Section Break
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Total
$0.00
Seat Validation
Online Validation

Payment Methods
Accepted

Practice Info
Number of Practices*
How long have you owned this practice(s)?*
Is this a Startup or Acquisition?*
Practice Management Software*
Number of Associates?*
Number of Full-time Hygienists?*
Number of assistants?*
Number of front office staff*
Number equipped operatories?*
Number UN-equipped operatories?*
Hours of Operation*
Please describe your team and practice culture, areas of opportunity, staff issues, culture, training needs, etc*
Goals
Goals for the practice*
What causes the most stress in your practice?*
What inspired you to sign up for seminar?*
Patients
Active Patients - Total active patient base*
Average new patients per month*
How far booked out are you for treatment?*
How far booked out are you for hygiene?*
What are your main forms of marketing?*
Insurance Mix - Please tell us what your patient mix is
FFS Percentage*
PPO Percentage*
Medicaid/State Percentage*
Production
Current YTD Production*
Current YTD Doctor Production*
Current Hygiene Doctor Production*
AR
Current*
31-60 Days*
61-90 Days*
>90 Days*
Total*
{Seminars:196} - {Dates:143}{Dates:198}{Dates:153}{Dates:155}{Dates:159}{Dates:158}{Dates:157}{Dates:156}{Dates:154}

Total - {Total:48}

Payment Methods
Accepted

Choose Seminars

Choose Preferred Date

Select Number of Seats for Advanced Practice Acquisition

Select Number of Seats for Advanced Startup

Select Number of Seats for Business Masters

Select Number of Seats for Business Masters in Las Vegas

Select Number of Seats for Group Practice Ownership

Select Number of Seats for New Dentist Bootcamp

Select Number of Seats for Office Manager Mastery

Select Number of Seats for Practice Acquisition

Select Number of Seats for Transformation Retreat

Section Break

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Event Registration

We are unable to process your registration at this time. Please contact us at [email protected] Thank you!

Additional Attendees

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Attendee 9

Attendee 10

Section Break

Practice Info

Goals

Patients

Insurance Mix - Please tell us what your patient mix is

Production

AR

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