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About
Services
Personal Planning
Business Planning
High-Net-Worth Financial Planning
Resources
Calculators
Blog
Weekly Market Recap
Events
Form CRS
Client Login
Investor360
Mass Mutual
Schedule A Phone Call
The Dental Practice Profit & Financial Security Score™ Tool
Quickly Reveal the Health of Your Practice and Your Wealth Potential
Contact Information
Name
First
Last
Dental Practice Name
Professional Email
(Required)
Cell-Phone Number
Practice Profitability
Annual Practice Gross Revenue
Please Select
Less than 250k
More than 250k but less than $500,000
$500,000 – $999,999
$1,000,000 – $1,999,999
2,000,000+
More than $3,000,000
Annual Personal Net Revenue
Please Select
Less than 250k
More than 250k but less than $500,000
$500,000 – $999,999
$1,000,000 – $1,999,999
2,000,000+
More than $3,000,000
Annual Dental Practice Overhead Expense %
Please Select
Less than 40%
40% - 50%
50% – 60%
60% – 70%
71% – 80%
More than 80%
Top 3 Dental Practice Office Expenses
(Some example expenses: Rent/Salary, Realestate, Employee/Staff Salaries, Medical Supplies, Lab Fees, Technology Cost, or Client Acquisition / Marketing Costs)
Dental Practice Office Expense # 1
Please Select
Rent/Salary
Real-Estate
Employee/Staff Salaries
Medical Supplies
Lab Fees
Technology Cost
Client Acquisition / Marketing Costs
Select a Category for the Expense
Dental Practice Office Expense # 2
Please Select
Rent/Salary
Real-Estate
Employee/Staff Salaries
Medical Supplies
Lab Fees
Technology Cost
Client Acquisition / Marketing Costs
Select a Category for the Expense
Dental Practice Office Expense # 3
Please Select
Rent/Salary
Real-Estate
Employee/Staff Salaries
Medical Supplies
Lab Fees
Technology Cost
Client Acquisition / Marketing Costs
Select a Category for the Expense
Personal Wealth Efficiency
Current Savings Rate
Please Select
Less than 5%
5% – 15%
15% - 25%
25% or more
Select your appropriate annual saving %. IRA, Taxable account, Roth IRA, 401k, Saving Accounts, Profit Sharing Plans, Cash Balance Plans, 412I Plans, and Commodities are examples of savings instruments.
Examples of types of saving instruments include the following: Please check the box of the following saving instruments that you are currently participating in.
401(k) / 403(b) / 401(a)
457(b)
Roth IRA
Traditional IRA
HSA
Taxable Brokerage Account
457(f)/NQDC
529 Education Savings
412(e)(3) Planning
Commodities / Real Estate
ESPP
I would love to learn more about the following financial saving instruments - Check all that apply:
401(k) / 403(b) / 401(a)
457(b)
Roth IRA
Traditional IRA
HSA
Taxable Brokerage Account
457(f)/NQDC
529 Education Savings
412(e)(3) Planning
Commodities / Real Estate
ESPP
Financial Independence / Retirement
Which of the Following Profit Allocation Strategies Do You Use? Select all that apply
I automatically transfer a percentage of revenue to savings monthly
I contribute annually to tax-advantaged retirement accounts
I have a personal investment or wealth-building account
None of the above
Personal Wealth Financial Review - I review my financial plan:
Once a Month
Once a Quarter
Semi-Annual
Annual
Proactive Tax Planning / Review
Yes, I perform mid-year proactive tax review with a CPA
No, I do not perform mid-year proactive tax review
Protection, Legacy planning and Business Continuation Planning (check all that you currently participate in)
Disability Income Insurance
Disability Business Overhead
Key Person / Business Continuity Coverage
Life Insurance Income Replacement
Long-Term Care Income Planning
Up-to-date Will and/or Trust
Business Succession or Exit Plannning
Business Liability Umbrella Policy
I have completed my Will / Trust Planning in the last 5 years
I have Student Loan Debt
I am currently working on purchasing additional dental practices
I have a future goal to purchase additional dental practices
I plan on Selling to Private Equity or to a DSO in the next 5 years
I would love to learn more about the following Financial Solutions - Check all that apply:
Exit Strategy Planning
Transfer on Death (TOD): What It Is and How It Helps
Three Key Estate Planning documents that everybody needs
Long-term Care Planning
The Types of Estate Planning Trust, & How They are Used
How Life Insurance Is used in Estate Planning
Financial Independence
Score Calculation
Your Practice Profit & Security Score™:
(Automatically calculated upon form submission)
Annual Dental Practice Overhead Expense % (40 pts max)
Less than 40%: (40 pts)
40% - 50%: (35 pts)
50% – 60%: (30 pts)
60% – 70%: (20 pts)
71% – 80%: (10 pts)
More than 80%: (5 pts)
Current Savings Rate (30 pts max)
Less than 5%: (5 Pts)
5% – 15%: (15 Pts)
15% - 25%: (25 Pts)
25% or more: (30 Pts)
Personal Wealth Financial Review (15 pts max)
Once a Month: (15 pts)
Once a Quarter: (12 pts)
Semi-Annual: (10 pts)
Annual: (5 pts)
Proactive Tax Planning / Review (15 pts max)
Yes, I perform mid-year proactive tax review with a CPA: (15 pts)
No, I do not perform mid-year proactive tax review: (0 pts)
Total Score:
What’s the one financial issue that potentially keeps you up at night that you want off your plate this year?
CRN202809-9516989
