My practice/I need(s)

    SELECT YOUR OPTION

    HPP 1:1 VIP Coaching Program (Application and Phone Interview Required)
    • Customized and Unique Coaching That Is Designed Specifically For You and Your Practice(s)

    • Initial Strategic Planning Session To Fast Track Your Progress and Results

    • Regular Phone Calls To plan, strategize and discuss step by step implementation into your life/practice

    • Anytime Email Access and Emergency Calls

    Bonuses:  VIP coaching members receive these Complimentary Bonuses....

    • Hard cover copy of Dr. Justin Bhullar’s Book: High Performance Practice: Management, Marketing, and Leadership ($27.97 Value)

    • Full Access To Our Premier Online Training Platform, “DentalBusinessMentor.com” (Over 180+ training Videos and Documents To Get Your Practice to The Next Level) ($1997 Value)

    • Invitation for a 1:1 Coaching Day At Dr. Justin Bhullar’s Home In Tampa, Florida. ***OPTION: To do full day zoom session or post pone until the following year(Value: $5,000).

    • Google Review Booster ($399 Value)

    • The Real Solution To No Shows and Cancellations ($399 Value)

    • 10x Internal Referral Protocol ($399 Value)

    • 3-Step Guide To Increase Your Revenue and Keep Your Hygiene Chairs Full ($197 Value)

    • Plug and Play Office Policy Manual ($197 Value)

    • Total Value Of All Bonuses: $8615.97

    Optional VIP Membership Add On
    • 1 Full Day of Live Training At Your Practice For You and Your Team

    • Dr Justin and His Team Come To You

    • All Travel and Related Expenses Included

    ***You let us know what your needs are and we will customize a training plan for you and your team

    Please Chose Your Preferred Coaching Option Below (2 to chose from):

    Month to month $3,500/month

    OR

    12 Month Fast Track Program: $2500/month (Save: $5000 when paid as lump sum)

    • Customized and Unique Coaching That Is Designed Specifically For You and Your Practice(s)

    • Initial Strategic Planning Session To Fast Track Your Progress and Results

    • Regular Phone Calls To plan, strategize and discuss step by step implementation into your life/practice

    • Anytime Email Access and Emergency Calls

    Bonuses: VIP coaching members receive these Complimentary Bonuses……

    • Hard cover copy of Dr. Justin Bhullar’s Book: High Performance Practice: Management, Marketing, and Leadership ($27.97 Value)

    • Full Access To Our Premier Online Training Platform, “DentalBusinessMentor.com” (Over 180+ training Videos and Documents To Get Your Practice to The Next Level) ($1997 Value)

    • Invitation for a 1:1 Coaching Day At Dr. Justin Bhullar’s Home In Tampa, Florida. ***OPTION: To do full day zoom session or post pone until the following year(Value: $5,000).

    • Google Review Booster ($399 Value)

    • The Real Solution To No Shows and Cancellations ($399 Value)

    • 10x Internal Referral Protocol ($399 Value)

    • 3-Step Guide To Increase Your Revenue and Keep Your Hygiene Chairs Full ($197 Value)

    • Plug and Play Office Policy Manual ($197 Value)

    • Total Value Of All Bonuses: $8615.97

    Optional VIP Membership Add On: In House Training $5000

    • 1 Full Day of Live Training At Your Practice For You and Your Team

    • Dr Justin and His Team Come To You

    • All Travel and Related Expenses Included

    ***You let us know what your needs are and we will customize a training plan for you and your team

    ***All FEES ARE IN USD

    IMPORTANT: If you prefer to speak to Dr. Justin prior to filling out an application form please set up a time to utilize your Free 30 Min Call with Dr. Justin Today

    **(Please note ALL information is kept completely Confidential)**


    Less than $100,000$100,000-$250,000$250,000-$500,000$500,000-$750,000$750,000-$1,000,00$1,000,00+


    40+30-4020-3020-10less than 10

    Being completely honest with yourself, do you know you are working a little harder than you would like to?

    YesNo




    (attach additional sheet of information if necessary)

    Number of hours you work, average week

    No of hours you'd prefer to work, average work

    % of work-time you rank as productive

    No. of hours per week you work "on" vs. "in" your business

    No. of Weeks of vacation you'd prefer taking:

    High Performance Practice Coaching and Mastermind Program(s)

    Participation Agreement Terms and Conditions

    I understand and commit to working with total integrity, honesty, and confidentiality with other members of this Special Coaching Group of like-minded high achievers. I understand and agree that, by completing and signing this enrollment form, if accepted into a program, I will have my credit card(s) charged for the participation rates described for my selected program (a member of the HPP team will contact you to collect this cc information or discuss your preferred method of payment. Options include: a) credit card b) bank draft or certified cheque available only to those choosing the lump sum option). I agree by signing this agreement for products and/or services stated herein, I am solely and completely responsible for any indebtedness incurred, as a result of my entering into this agreement with High Performance Practice LLC and therefore I am responsible for the complete and total amount due to High Performance Practice LLC.

    I understand and agree that by completing and signing this enrollment form that I am committing to a full twelve (12) month period in the program from the date of official acceptance (you will be notified via phone and email of this exact date). I further understand and agree that, if, for any reason, I choose to remove or cancel myself out of the program I must give 30 days prior written notice and return any and all intellectual property distributed to me. Further, I fully understand the program details and acknowledge that Dr. Justin Bhullar or High Performance Practice LLC or any representative neither promises or guarantees any verbal or written results with relation to myself or my business and that all actions and results are up to me. I therefore hold harmless Dr. Justin Bhullar and High Performance Practice LLC, or any representative from any/all claims that may arise from the participation in this program. High Performance Practice LLC as the sole discretion to terminate this agreement and remove any participant from continuing in the program at any time if the participant is disrupting the program or is difficult to work with, becomes difficult to work with, or ceases to follow any of the coaching program guidelines. I understand that as a coaching member I will be asked to sign a confidentiality and non-compete document that protects the intellectual property of high performance practice LLC from being reproduced or sold to any third parties without the expressed written consent of High Performance Practice LLC.

    Print Name:

    Sign:

    Date:

    Contact : drjustin@highperformancepractice.com
    Cassie Forgo, Executive Assistant : cassie@highperformancepractice.com

    Toll Free: 1-800-464-9077

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