Kristin DeEugenio - Making MŪVs Mail - New Intake Form Submitted!
This document is an Airtable automation email containing a new client intake form submitted on September 22, 2025 by Kristin DeEugenio for REALM Chiropractic, LLC. The form captures comprehensive contact information (personal and office phone numbers, email addresses, home and office addresses), business credentials (legal name, EIN, website, Instagram profile, logo upload), service offerings (spinal health screening, chiropractic exam, personalized recommendations, relief treatment, home physical therapy program), pricing ($260 new patient exam), operational preferences (notification channels, area‑code preferences, phone outreach person, call forwarding decision), marketing objectives (wants to learn how to dramatically increase traffic with qualified patients using videos and expects immediate feedback on any issues), insurance stance (does not accept insurance), reputation metrics (16 five‑star Google reviews, link to reviews), and other logistical details (start date, time zone, area‑code preferences). The submission also includes consent for photo use and a request for a 10/10 experience focused on video‑driven patient acquisition.
Topics
Client Identity and Contact Details
Personal name, phone numbers, email addresses, home address, and office line for Kristin DeEugenio and REALM Chiropractic.
Business Credentials and Online Presence
Legal business name, EIN, website URL, Instagram handle, uploaded logo and headshot, and tax‑address details.
Service Portfolio and Pricing
Core chiropractic services, home physical therapy program, and the $260 full‑price new patient exam offering.
Marketing Objectives and Success Criteria
Client’s primary goal to dramatically increase qualified patient traffic using video content and expectations for rapid issue resolution.
Operational Preferences and Notification Settings
Preferences for text and email notifications, area‑code preferences for outreach numbers, decision on forwarding GHL calls, and identification of the primary outreach staff member.
Reputation Metrics and Insurance Policy
Current count of 16 five‑star Google reviews, link to reviews, and statement that the practice does not accept insurance.