Application for Smart Success Healthcare
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Question 1 of 17
What is your best email?
Question 2 of 17
What is your cell phone number?
Question 3 of 17
How long have you been following Greg Todd?
Less than a week
Less than a month
Less than 6 months
Over 6 months
Question 4 of 17
Who referred you or how did you hear about us?
Facebook ad
Youtube
Instagram
Facebook live stream
Hunt for Greatness Podcast
Person
Question 5 of 17
If someone referred you to SSPT, please state the name of the person. Please put "N/A" if no one referred you.
Question 6 of 17
Where are you in your career?
Pre-PT Student
DPT Student
DPT
Practice Owner
OT
Other
Question 7 of 17
How do you currently make money?
Question 8 of 17
Rate your current marketing skills 1-5 (1 - Poor, 5 - Excellent)
1
2
3
4
5
Question 9 of 17
Rate your insurance and reimbursement knowledge 1-5 (1 - Poor, 5 - Excellent)
Question 10 of 17
Rate your online product and creation (creating digital products, courses and telehealth) skills and knowledge 1-5 (1 - Poor, 5 - Excellent)
Question 11 of 17
Rate your financial literacy 1-5 (1 - Poor, 5 - Excellent)
Question 12 of 17
Where would you current rate yourself on the PT profit pyramid?
Rookie
Starting Lineup
All Star
Legend
Question 13 of 17
Where would you like to end up on the PT profit pyramid?
Question 14 of 17
What made you apply today of all days?
Question 15 of 17
Why is now the best time for you to take action?
Question 16 of 17
I understand that Smart Success PT is an INVESTMENT and is in NO WAY a GET RICH QUICK SCHEME!
YES
NO
Question 17 of 17
I understand that in order to get results I must COMMIT to completing all the lessons in SSPT and implement. I understand that this is a SUCCESSFUL process, but a process nonetheless!