Quentre Shannon - Making MŪVs Mail - New Intake Form Submitted!

PDF · 24 Sept 2026

This document is an Airtable‑generated intake form submitted by Quentre Shannon on behalf of Legacy Chiropractic, Inc. for the Making MŪVs service. It captures comprehensive business and personal contact information (emails, phone numbers, office address, time zone), legal identifiers (EIN, LLC name), and operational preferences (call forwarding, notification channels). The form outlines the client’s expectations for a 10/10 experience (steady flow of 20‑40 new patients per month, transparent communication, strategic planning) and dissatisfaction triggers (low ROI, poor communication, lack of adjustments). It details the practice’s service offering, including a $250 full‑priced new patient exam with specific components, core chiropractic modalities, and additional stretch therapy. Marketing assets are provided (website, Instagram handle, logo upload, professional headshot) along with a link to Google reviews (94 five‑star reviews). Insurance acceptance (multiple major carriers) and a historical patient count (≈1,000) are also listed. The form records preferences for call forwarding to the office line, text and email notifications for leads, and area‑code preferences. Overall, the intake captures the essential data needed to set up and manage the client’s marketing, lead‑generation, and communication workflows within the Making MŪVs platform.

Topics

Comprehensive Business and Contact Information Capture

All essential identifiers for Legacy Chiropractic, including legal name, EIN, office address, personal and business emails, phone numbers, time zone, and social media handles.

Client Success Expectations and Failure Triggers

Quentre’s criteria for a 10/10 experience (20‑40 new patients monthly, transparent communication, strategic planning) and factors that would make the engagement unsatisfactory (low ROI, poor communication, lack of adjustments).

Service Offering, Exam Pricing, and Clinical Modalities

Details of the new patient exam ($250) and its components, core chiropractic services (Diversified, at‑home exercises, intersegmental traction, Denneroll), and additional stretch therapy.

Marketing Assets and Online Presence

Website URL, Instagram handle, uploaded business logo, professional headshot, and Google review link with 94 five‑star reviews.

Operational Communication Preferences

Preferences for call forwarding to office line, text and email notifications for leads, area‑code preferences, and notification channels.

Insurance Acceptance and Patient Volume History

List of accepted insurance carriers and historical count of approximately 1,000 new patients seen over the chiropractor’s career.

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