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45 Day Free Trial (Acquisition Manual)

Thank you for purchasing the Dental Acquisition Manual!

Fill out the form below to claim your 45 day DSN free trial!

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Name*
First Last
Preferred DSN Email Address*
(Your Future Login if Accepted)*
Cell Phone Number*
Please provide the best cell number to receive the most up-to-date news and announcements. We will never spam you or share your info with anyone.

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Clinic Name*
Simply part of the vetting process (even if not an owner, we want to learn about where you work)
How many clinics are you an owner in, if any?*
If an Associate, enter 0.
Please enter a number from 0 to 99.
Dental License Number*
AGD Number*
Are you a member of the AGD? If so, please provide AGD number for online CE submission.
Annual Revenue*

Shirt Size
DSN provides our partners with a list of our members and contact information so you don’t miss a beat in savings with suppliers you may already be using!*
We understand and value our member's privacy. If sharing your office information with our partners is something you would like to opt-out of, we get it! Simply click "Do not share my information".
- Yes, share my information with DSN vendors
- No, do not share my information with DSN vendors
What part of the Dental Success Network are you most interested in?*
- Savings & Vendor Discounts
- Team Training
- Continued Education
- Startup & Acquisition
- Growing My Practice
What three challenges can we help you solve?*
*Please Select Three
- Systemization Implementation
- Team Culture
- Become a Better Leader
- Understanding Cash Flow
- Inventory & Overhead Control
- Understanding My Business

DSN Membership
Click here to view the DSN terms and conditions.
Untitled*
- I agree to the DSN terms and conditions.
Consent*
CANCELLATION POLICY: Members can cancel at ANYTIME. All cancellation requests must be submitted through the “Contact Us” form located anywhere on the site. All cancellation requests submitted 24 hours prior to invoice due date will be charged. However, Dental Success Network will refund the total invoice amount. Any cancellation request submitted over the weekend will be reviewed and processed the next business day. For questions regarding DSN’s cancellation policy please contact
support@dentalsuccessnetwork.com
REFUND POLICY: All refunds are processed at DSN discretion excluding members who request to cancel membership within 24 hours of invoice due date. Members who have requested to cancel their membership within 24 hours of the invoice due date can expect a full refund. Refunds will not be processed to non-usage of the network.
For questions regarding DSN’s cancellation policy please contact support@dentalsuccessnetwork.com
I agree to the Cancellation/Refund Policy.
If you were referred to DSN by an existing member, enter their first and last name here:

Finally, you understand that, if accepted, there is a monthly membership fee of $199 per month once your 45 day free trial expires*
This is a NO CONTRACT, CANCEL ANYTIME approach because we want you in Position #1...finally. Why pay? Communities that pay, pay attention. This ensure we have a high-quality group of Members and that we can pay our EXPERTS and the most influential people in dentistry paid to pay attention to YOU! Synergy will NOT be included during your 45 day free trial *
- Yes
Credit Card*
Card Details
Cardholder Name

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(928) 968-3505

EMAIL

support@dentalsuccessnetwork.com

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