Please fill out this quick 15 question survey as accurately and completely as possible.
This survey allows us to make sure Access 2 Integration is a good fit for you, your patients, and for us.
The purpose of this survey is to make sure you and Access 2 Integration (A2I) are a good fit, and we thank you in advance for your time.

What is your full name? *

What is your cell phone number? *

This number will only be used to contact you regarding your survey.
What is your email address? *

This email address will only be used to contact you about your survey.
What is the city, state, and zip code in which your practice is located? *

How many patients do you see per week? *

How many new patients per month do you see? *

Which services that A2I offers are you most interested in implementing? *

If you don't add more revenue to your practice what will that mean for you in the next 5 to 10 years? *

Do you have the financial resources on hand or a line of credit to pay for the A2I program and the initial start up expenses? *

We want to make sure that you are financially prepared before working with us.  Financing options are available if you need them.
Do you need information about financing recommendations? *

Do you have additional questions that you'd like to ask or discuss when we speak with you? *

Are you willing to hold an education talk at least once a week? *

Are you willing to invest at least $2,500 per month to market your Regen Med services? *

Did someone refer you to A2I?

Please list their full name/names.

Thank you for filling out the survey.  We will be in touch very soon to schedule a time to talk with you.  If you have urgent question and need to speak to someone sooner, please call us at (317) 527-1113.

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