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Member List
Upcoming Events
Presentation Library
Accountability Groups

Menu

Member List
Upcoming Events
Presentation Library
Accountability Groups

Upcoming Events

2021 – May 14th & 15th

Austin, TX

2021 – July 30th & 31st

Park City, UT

2021 – September 24th & 25th

Sedona, AZ

*Women’s Event Only*

2021 – November 5th & 6th

New Orleans, LA

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Copyright © 2021 Ultimate Achievers Club Ι 803 Silver Ave SW Albuquerque, NM 87102

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Application Form

Step 1 of 3

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Basic Information
Name*
First Last
Email*
Cell Phone*
Chiropractic School Attended*
Year Graduated*

Please enter a value between 1940 and 2020.
Who invited you to join the UAC?*

Practice Information
Name of Practice*
Years in practice?*
Do you have more than one practice?*
- Yes
- No
How many practices do you have?*

Please enter a value between 1 and 5000.
Do you own businesses in addition to your chiropractic practice?*
- Yes
- No
What is the central focus of your practice?*
What type of business do you have to support the chiropractic profession?*
- Own a practice
- Own a business that serves the profession
- Both
Please list current annual revenue from each of these businesses*
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Please list current annual revenue from each of these businesses*

Please enter a value between 1000 and 200000000.
What are your current average visits per week?*

Please enter a value between 10 and 5000.
How many employees/contractors do you have?*

Please enter a value between 1 and 500.

Digging Deeper
Who would you call your mentor(s)?*
What is your Superpower?*
What is your Kryptonite?*
What do you hope to share with the group?*
What do you hope to learn from the group?*
What do you hope to teach to the group?*

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