Site Visit Report - duplicate

• Site conducted

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• Division

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• Region

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• Clinic

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• Conducted on

  Date

• Prepared by

• Names of Team Member/s

• Celebrate Accomplishments

• Agenda for Today’s Visit Site

• Site Visit Report with:

  Clinician

  Clinic Coordinator

Sales Data

• In the boxes below, please list this month (TM), last month (LM) and year to date (YTD)

• Revenue Rate % to Budget

• TM:

• LM:

• YTD:

• Closing Rate

• TM:

• LM:

• YTD:

• Top-up Rate

• TM:

• LM:

• YTD:

• ASP

• TM:

• LM:

• YTD:

• Other

Sales Data

• In the boxes below, please list last month and MTD results

• Sales Revenue % to budget

• TM:

• LM:

• YTD:

• Tests Completed

• TM:

• LM:

• YTD:

• Appointment Completion

• TM:

• LM:

• YTD:

• Aidable Loss Rate

• TM:

• LM:

• YTD:

• 3rd Party

• TM:

• LM:

• YTD:

• Other

Site Visit Observation

• Activity Observed - Please comment under each item listed below

• Morning Huddle

• Observation 1

• Observation 2

• Opportunity Creation

• Other Discussion

Action Plan

• Areas of Development and Agreed Upon Next Steps

• Specific Observation and Detail Agreed Upon Next Steps:

• Enter Follow-up Date

  Date

• Specific Observation and Detail Agreed Upon Next Steps:

• Enter Follow-up Date

  Date

• I have reviewed the content of this Site Visit Report with my Manager

  Sign

• Manager Signature

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