JLW Medical Black Friday Initial Consultation & Service Enrollment Form

JLW Medical Black Friday Initial Consultation & Service Enrollment Form

Please complete the entire form in it's entirety before submitting.
How did you Hear About Us?
Practice/Company Name
Full Name

First NameLast Name
Title/Position:
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer Identification Number (EIN#)
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If you were referred by one of our partners, please let us know who referred you.
Which Black Friday Service Are You Interested In?
Which Black Friday Deal are you Most Interested In?
Would you like to be referred to our partner, Thrivory, to determine whether your practice qualifies for monthly reimbursement advances of up to 80% of your total monthly claims?
Brief Description of Your Concerns
Upload Supporting Documentation

Please upload outstanding/aging revenue report
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Select Your Consultation Date
Initial Consultations
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Initial Consultation + Follow-Up Call
Our Initial Consultation includes a 2-hour assessment (or two 60-minute sessions), a follow-up call, 20-hours of research, a personalized action plan, and a proposal outlining services and pricing. You’ll receive expert insight into your revenue cycle, operations, and growth barriers. Plus, we’ve added a complimentary Revenue Risk Review: a quick, surface-level diagnostic tool that identifies red flags and provides clarity within 24–48 hours while your consultant prepares your full assessment. Standard consultation price is $1,250 unless otherwise noted in a promotional offer or due to market fluctuations. Recommended action plans and service proposals are typically prepared and delivered within 2–3 weeks of the initial consultation.

$1,250.00

Total

$0.00
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JLW Medical Black Friday Initial Consultation & Service Enrollment Form

Initial Consultations *

Payment Methods

Initial Consultations