"Yes, Michael! I am interested in taking my practice to the next level! Please consider my application for the coaching program starting July 16th, 2019, and, if accepted, book my appointment for an appointment to find out if I'm a good fit for the Successful Practice Secrets Program."
"I understand there is a $500 refundable application fee, which will either be refunded if I am not accepted or choose not to join, or applied to the program if I do join."
There is no obligation to join when filling out this application. Not everyone who enrolls is accepted and not everyone who accepted joins. This is just a way to explore whether you are a good fit for this program and vice versa.
Please complete this confidential application and submit it as soon as possible. It is important that we receive your fully completed and refundable deposit before we can move forward.
Incomplete forms will be deleted with no warning.
Please submit your completed form by hitting the "Click to Apply" button at the bottom of the form. In order to protect your privacy, DO NOT EMAIL THIS FORM. This page uses 100% secure encryption to protect your sensitive information.