Your Personal "Practice Health" Quiz

FIRST NAME _____________________________________
LAST NAME _____________________________________
EMAIL _____________________________________

Ready? Just print this form, tick Yes or No as you answer, and send to The Centre for Powerful Practices! There are 35 questions, some with different parts.

1.

Are your hours listed on your door, or your appointment card, or your 'Welcome to Clinic' letter, etc?

YES NO
     
2. Have you formally assessed and reviewed your clinic furnishings, ambience, policies and procedures in the past year? YES NO
     
3. Do you have more than one phone line for incoming calls?  YES NO
    Do you have 'message' or 'music' on hold? YES NO
    Do you use a chiropractic-specific message on hold? YES NO
     
4. Do you use an answering machine or answering service?  YES NO
    Is your phone attended out of office hours? YES NO
     
5. Do you record your practice statistics daily? YES NO
    Including Accounts Receivable Total? YES NO
    Including 'no charge' total? YES NO
     
6. In your appointment book:  
    Are special visits (eg New Patient) recorded? YES NO
    Are totals kept? YES NO
    Are multiple appointments made in advance for patients? YES NO
    Do you have a colour-coded system in your appointment book? YES NO
     
7. Have you established recall systems? YES NO
  For: Missed appointments? YES NO
    Reminder calls? YES NO
    Rebooking archived patients after e.g. 6 months? YES NO
     
8. Do your patients print their names on an Arrival Register?   YES NO
    Do you retain these registers for your records? YES NO
     
9. Are New Patient Files prepared in advance? YES NO
     
10. Do you have an established written Office Policy and Procedure Manuals? YES NO
    For patients? YES NO
    For staff? YES NO
    For locums? YES NO
    For associates? YES NO
    For cleaners and gardeners? YES NO
     
11. Do you give written Report of Findings and schedule of visits? YES NO
    Are spouses/partners actively invited? YES NO
     
12. Do you send:  
    Birthday cards? YES NO
    Welcome letters? YES NO
    Thank yous or appreciation notes? YES NO
    Thank you for referral cards or letters? YES NO
    Special occasion cards? YES NO
     
13. Do you give Health Care/Spinal Care/Special Appointment/Wellness Workshop classes?  YES NO
    Are they integral for New Patient's? YES NO
    Do you request that your patients bring a spouse/partner or friend/s?  YES NO
     
14. Do you have team meetings at least every 2 weeks? YES NO
    Do you use an agenda? YES NO
    Do you regularly acknowledge positive contributions by the team? YES NO
    Do you keep personal correction AWAY from the team meetings?  YES NO
     
15. Do your team members wear uniforms? YES NO
    Do your team members wear name tags? YES NO
     
16. Do you and your team review appropriate scripting? YES NO
    Do you and your team regularly role play scripting? YES NO
     
17. Do all your team members have regular chiropractic care? YES NO
    Do the family members of your team have regular chiropractic care? YES NO
    Do your family members have regular chiropractic care including re-exams and re-xrays? YES NO
     
18. Have you had your insurance needs reviewed and adjusted by an insurance professional in the last two years? YES NO
    Do you have malpractice insurance? YES NO
    Do you have personal sickness/accident insurance? YES NO
    Do you have a ‘Pension Plan' in place that will provide for all your lifestyle needs when you retire? YES NO
    Do you use the services of a qualified Financial Planner? YES NO
     
19. Please indicate if you are using the following forms:  
    Confidential Case History? YES NO
    Daily Practice Statistics Log? YES NO
    X-Ray Release? YES NO
    General Patient Information Release? YES NO
    Office Policy? YES NO
    Arrival Register? YES NO
    Written Report of Findings? YES NO
    X-ray Log Book? YES NO
    Initial Physical Examination? YES NO
    Progressive Physical Examination? YES NO
    Comparative Physical Examination? YES NO
    Subjective Progressive Patient Questionnaire? YES NO
    Subjective Comparative Patient Questionnaire? YES NO
    Health Index Patient Questionnaire? YES NO
    Automobile Accident Questionnaire? YES NO
    Children's Examination? YES NO
    Recent Patient History? YES NO
    Fee Schedule? YES NO
     
20. Do you give each patient an Emergency Care Card (i.e. patient's vital information for use when out of town)? YES NO
     
21. Please indicate if you are using the following:  
    One Write or Computer System? YES NO
    Repairs Book? YES NO
    Team Meeting Diary? YES NO
    Telephone Message Book? YES NO
    Communications Diary? YES NO
    Library Loan Book? YES NO
    Video Loan Book? YES NO
    X-Ray Release Book? YES NO
    Mail, Sent/Received Book? YES NO
     
22. Do you regularly attend:  
    Chiropractic continuing education seminars? YES NO
    Financial planning/investment seminars? YES NO
    Personal growth seminars? YES NO
    Chiropractic Association Meetings? YES NO
     
23. Are you actively involved in at least one local community service, school, sporting or special interest group? YES NO
     
     
24. Do you regularly read books associated with professional and personal development, excellence or life principles, business management or inspirational works? YES NO
     
25. Do you take regular holidays? YES NO
     
26. Do you take at least one full day per week away from the office? YES NO
     
27. Do you participate in a mentor program or Mastermind group? YES NO
     
28. Do you have a clinic newsletter at least 4 times per year? YES NO
     
29. Do your staff attend CA training seminars? YES NO
     
30. Do you have special staff appreciation days or evenings or do you reward your staff with incentive/performance bonuses or special gifts? YES NO
     
31. Have you personally or with your team identified at least 50 characteristics of your ideal patient? YES NO
     
32. Do you have a written statement of purpose? YES NO
     
33. Do you have practice Mission and Vision Statements? YES NO
     
34. Do you have written goals:  
    For your personal life? YES NO
    For your practice? YES NO
    For your financial future? YES NO
     
35. Do you know what your 'net worth' is? YES NO
       

Phew! Well done! Thank you for taking the time to fill this out