Name

Phone Number

Chairside Videos

Waiting Room TV

Website Videos

All

Practice Name

Practice Domain Address

Practice Address

Contact Name

Job Title

Contact Email

Contact Phone Number

Is the practice a Dental Whale + member?

Is the practice a Breakaway Practice?

Does the practice have an existing patient education solution?

Does the practice have a TV in its waiting room?

Would the practice benefit from a webinar on the Thalamus Patient Education Solution?

Does the practice want 50 Free Videos for their website courtesy of Dental Whale?

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