Customer Avatar Survey
1. Full Name
2. Typical Age Range (select one or more)
18–24
25–34
35–44
45–54
55–64
65+
3. Predominant Gender (select one)
Female
Male
Equal Mix
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4. Where do most of your patients live? (select one)
Within the city/local
Nearby regions (within 1–2 hours)
Out-of-state or long distance
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5. What best describes your typical patient’s lifestyle? (select all that apply)
Working professionals
Entrepreneurs or business owners
Students or recent graduates
Stay-at-home parents
Retirees
Active/social lifestyle
Health and wellness conscious
6. Income Level (select one or more)
Less than $50,000/year
$50,000–$100,000/year
$100,000–$200,000/year
More than $200,000/year
7. What are your patients typically looking to achieve? (select all that apply)
Improve self-confidence
Address physical discomfort
Enhance appearance or aesthetics
Recovery from an injury or medical condition
8. What concerns do patients commonly express before scheduling a procedure? (select all that apply)
Cost or financing concerns
Safety and risks
Recovery time and impact on daily life
Potential pain or discomfort
Results not meeting expectations
9. Where do most of your patients first hear about your practice? (select one or more)
Google search
Social media (Instagram, Facebook, TikTok, etc.)
Referrals from past patients
Referrals from other medical providers
Online reviews or rating websites
Influencers or celebrities
Traditional media (TV, radio, print)
10. What type of content most effectively attracts your ideal patient? (select all that apply)
Before-and-after photos
Patient testimonials and stories
Educational videos explaining procedures
Frequently Asked Questions (FAQs)
Blogs and written articles
Interactive Q&A sessions (live or virtual)
11. What format do your patients prefer for initial consultations? (select one or both)
Virtual consultations
In-person consultations
12. Which factors help your patients choose you over your competitors? (select all that apply)
Surgeon’s reputation or credentials
Patient testimonials and results
Cost/value
Technology or technique used
Patient experience or comfort during consultations
Office location/convenience
13. Describe your ideal patient in one or two sentences: (open-ended)
14. Any additional details you want to share about your patients or your ideal patient profile? (open-ended)
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