ADS Precise Consultants

Buying a Dental Practice

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Fill out and return the Buyer Forms

pdf_iconBuyer Forms

Whether you are fresh out of school, moving to a new area, or looking to improve an existing practice, buying an existing dental practice is often preferable to starting one from scratch. An established clientele, existing staff, and a facility ready for business can ease the startup process and allow you to get straight to the work you know best. But choosing and buying a practice is a process in which few people have prior experience.

At ADS Precise Consultants, we offer that experience, along with ready access to a wide selection of practices and associateships available in Arizona, Colorado, Wyoming, Nevada, Utah, Nebraska, and Kansas. With a wealth of information about each available practice and an expertise based in 25 years in the business, we are confident that we can help you find a practice perfectly suited to your needs.

We know that one size does not fit all, and that every dental practice must be fitted to the right buyer. The location, the client base, the financial status of the practice, and many more factors must be considered in determining whether each practice is compatible with you. Your ADS Precise Consultants will advise you on the possibilities most likely to fit your needs.

When assessing a practice for purchase, much of the information to be exchanged is confidential in nature. In order to protect both buyer and seller, as well as the business and value of the practice itself, we require that all prospective buyers complete a nondisclosure agreement. This agreement does not entail any cost or obligation aside from your confidentiality. You can print and complete this form to be returned by mail or fax, or use our online application at the bottom of this page. Please make sure you complete the entire form by filling in all required fields.

Once we have received the completed nondisclosure agreement, one of our brokers will contact you to learn exactly what you're looking for and how we can best meet your needs. The more information you can give us about your situation, your requirements, and your preferences, the better equipped we will be to assist you in finding the ideal dental practice.

Prospective Buyer/Associate Form

If you are interested in more information about practice purchase opportunities, we will need your promise of non-disclosure. This entails no cost or obligation other than your confidentiality. Please fill in this multi-page form below. If you have questions call us at (303) 759-8425.

Buying or selling a professional practice requires both parties to share substantial and confidential information with one another. Just as a Buyer needs information concerning a practice in order to evaluate it, a Seller needs some basic information about a prospective Buyer.




General Information


First Name of Buyer/Associate (*)

Please enter your first name.
Last Name Buyer/Associate (*)

Please enter your last name.
Email Address (*)

Please enter your email address.
Home Phone (*)

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Cell Phone

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Home Address (*)

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City (*)

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State

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Zip Code (*)

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Date of Birth (*)

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Spouse's First Name

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How did you hear about us? (*)









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Office Information


Office Address

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Office City

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Office State

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Office Zip Code

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Office Phone

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May we contact your office?

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Education



Professional Degree (*)

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Date Received (*)

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Dental School (*)

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Specialty/Residency

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Date Specialty/Residency Completed

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Dental Experience

(please list where & when you owned practices, were an associate, or had salaried positions and dates of each)

Name & Address

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Dates

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Name & Address

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Dates

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Licenses



State/Region

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License #

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Date

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State/Region

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License #

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Date

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Have you ever had a State Dental Board action against you?

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if yes please explain:

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Type of Practice/Position



GP/Specialty

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What are you interested in? Click all that apply.





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What are you interested in?



Please tell us your first priority (*)





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What is your second priority (*)





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What is your third priority (*)





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What is your fourth priority (*)





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States/Cities/Areas

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Please describe the characteristics of a practice that would interest you

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Practice Gross Revenue per year

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Practice Net Income per year

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Time Frame



By what date would you ideally want to purchase a practice or start as an associate?

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Do you need to sell a practice before you purchase a practice?



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If yes, please explain

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Financing the Purchase

If you will need a loan to purchase a practice, ADS Precise Consultants can usually assist you in securing financing, in an amount equal to 100% of the purchase price plus working capital, if needed. If you have been out of school for less than 2 years, the banks may require that you have a cosigner for the loan.


If you will need a loan to purchase a practice, ADS Precise Consultants can assist you in securing financing, in an amount equal to 100% of the purchase price plus working capital, if needed usually.

If you have been out of school for less than 2 years, the banks may require that you have a cosigner for the loan.

Would you like your contact information to be sent to lenders?



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Do you have any cosigners for a loan?



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Relationship

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Have you ever declared bankruptcy?



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If yes, please explain / What year?

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Are there any unsatisfied judgments against you or any business that you have owned?



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If yes, please explain

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Military Service/Specialty/Residency



Are you presently in:




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Branch

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Years Served

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Rank

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Date of Separation/Discharge/Completion

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Are you using a buyer's agent?



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If yes, who?

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ADS Precise Consultants has no obligation to and will not pay a buyer's agent. Notify us if you have signed a buyer's agent agreement with any firm.



NON-DISCLOSURE OF CONF IDENTIAL INFORMATION AND PROSPECTIVE BUYER/ASSOCIATE AGREEMENT

Please read in its entirety and check the box at the bottom of this page.

Your Legal Name (*)

Please enter your legal name.

This agreement is between “Buyer/Associate”, and ADS Precise Consultants hereinafter referred to as “Broker/Consultant”. This agreement shall be enforced in accordance with the laws of the State of Colorado. Buyer/Associate wishes to evaluate confidential information regarding practice opportunities presented by Broker/Consultant.

• Buyer/Associate recognizes that any confidential information provide him/her by Broker/Consultant or its representative regarding professional practices could, if disclosed, cause damage to the individuals disclosing the information and to Broker/Consultant.

• Therefore, Buyer/Associate agrees that he/she will not divulge, communicate, or otherwise disclose any confidential material provided by Broker/Consultant, its representatives, or clients of Broker/Consultant, to anyone, including employees, customers, clients or clients, with the exception of his/her spouse, accountant, and legal counsel.

• Buyer/Associate further agrees that his/her spouse, accountant, and legal counsel will maintain the confidentiality of the material as well.

• Confidential information shall include, but is not limited to, the following:

1. A professional intent to buy, sell, or associate.

2. Any financial data provided Buyer/Associate by Broker/Consultant, its representatives, or clients, which may include such items as value of practice under consideration, income statement or balance sheets, Internal Revenue Service returns, and any other personal financial data.

3. Any personal information provided Buyer/Associate by Broker/Consultant, its representatives, or clients, which may include such items as data regarding lawsuits, pending lawsuits, malpractice suits, or other items personally pertaining to the principals in these transactions.

4. Patient or client lists made known to Buyer/Associate during negotiations.

5. Buyer/Associate shall not contact any owner or staff member of an owner referred to Buyer/Associate by Broker/Consultant without the express permission of the owner.

6. Buyer/Associate agrees to return any and all information provided to Buyer/Associate to Broker/Consultant immediately upon request.

7. In addition, Buyer/Associate acknowledges the following:

8. Broker/Consultant is seller's agent and does not have any fiduciary duties to Buyer/Associate.

9. Information provided by Broker/Consultant is provided by the Seller and is not audited by Broker/Consultant. Broker/Consultant makes no claims as to the reliability of any such data.

10. It is Buyer/Associate's sole responsibility to conduct his/her own due diligence and confirm the accuracy of all information provided to Buyer/Associate by the owner and Broker/Consultant prior to any purchase.

11. Buyer/Associate indemnifies and holds Broker/Consultant harmless for any claim, loss or damages including expense of defense arising from any transaction agreed to by Buyer/Associate, including but not limited to court costs, reasonable attorneys' fees and investigation expenses which, in any manner, arise out of or result from any practice purchase, employment, or affiliation.

12. Buyer/Associate is advised prior to any purchase, to review all financial and tax records of any practice, as well as personally perform a patient chart audit (subject to HIPAA regulations), determine patient count, review insurance plans, review HMO contracts, and any other information needed by Buyer/Associate.

13. Buyer/Associate acknowledges that Broker/Consultant is not an accounting firm and not a legal firm. Buyer/Associate has been advised to retain the services of competent and experienced legal counsel to review all agreements and other documents to be executed in connection with the sale/affiliation. Advice or opinion on the advisability of entering into a transaction shall be provided by Buyer/Associate's legal counsel. Buyer/Associate agrees any disputes regarding this document and any future transactions between the Buyer/Associate and the seller and the Broker/Consultant shall be resolved by JAMS Arbitration.

14. Buyer/Associate acknowledges that Broker/Consultant may receive a fee, if any, from a lender for loan packaging and administration.

15. Buyer/Associate has been advised to retain the services of an accountant to evaluate the data and the terms of the affiliation or sale including any tax liability resulting from such sale/affiliation.

16. All information provided to Broker/Consultant by Buyer/Associate is true and correct to the best of Buyer/Associate's knowledge, and may be presented to the owner of any practice under consideration for employment or acquisition by Buyer/Associate.

17. Upon completion of a transaction with Buyer/Associate, Broker/Consultant shall be permitted to print, publish and mail its usual and customary professional announcement of the transaction.



(*)

Please acknowledge that you have read and agree to the terms.

Comments or Questions?

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