Confidential Buyer Application
Thank you for your interest! To protect the confidentiality of the practice, we ask all prospective buyers to complete this short application. Qualified applicants may be invited to sign a Confidentiality Agreement (NDA) before receiving access to the complete offering package, including financials, patient metrics, lease information, and the exact practice location. Estimated completion time: 3 minutes
SECTION 1: About You
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which best describes you?
*
Owner-Operator (I intend to personally practice in the clinic.)
Existing Practice Owner (Looking to expand.)
Investor / Absentee Owner
Other
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SECTION 2: Purchase Readiness
When are you hoping to acquire a practice?
*
Within 30 days
Within 60 days
Within 90 days
Within 6 months
More than 6 months
Assuming the practice meets your expectations during due diligence, are you prepared to purchase at the asking price of $295,000?
*
Yes
Yes, subject to due diligence
Potentially, depending on financing
I'd like to discuss the purchase price
How do you anticipate financing the acquisition? (Check all that apply)
*
Cash / Personal Funds
Conventional Bank Financing
SBA Financing
Seller Financing
Combination of the Above
Undecided
Have you already been pre-approved or pre-qualified for financing?
*
Yes
Currently in Process
No
Not Applicable (Cash Purchase)
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SECTION 3: Experience & Intent
Briefly describe your chiropractic or business ownership experience.
*
What interests you most about this opportunity?
*
Is there anything that could prevent you from purchasing this practice within your desired timeframe?
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SECTION 4: Confidentiality Acknowledgement
By submitting this application, I understand and acknowledge that:
• Submission of this application is an expression of interest only and does not obligate either party to proceed with a transaction.
• Completion of this application does not guarantee access to confidential information.
• Qualified applicants may be invited to execute a Confidentiality Agreement (NDA) before confidential information is released.
• The seller reserves the right to determine, at its sole discretion, which prospective buyers receive access to confidential offering materials.
• If approved, I agree to keep all confidential information private and not disclose it to employees, patients, vendors, competitors, or other third parties.
Submit Buyer Application
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