Buyer's Profile

Below you will find our confidential buyers profile. Please note that if you are looking at a practice for which Wiederman Potter Premium Practice Sales, Inc. is not the listing broker, (whether another broker is involved or not) we can perform due diligence on that practice once you have made an offer and it has been accepted. We have assisted hundreds of buyers in looking at the financial aspects of practice sales over the years. Please fax 714.259.0406 or email your resume upon filling out this Confidential Buyer's Profile. Fields marked with an asterisk (*) are required.

	Full Name:*
	Street Address:
	Suite:
	City:
	State:
	Zip:
	Home/Office Phone:*	--
	Cell Phone:	--
	Fax:	--
	eMail:*
	Area you would like to purchase a practice in (please put in your top three choices of cities/county in which you would like to practice):
	#1 Choice:
	#2 Choice:
	#3 Choice:
	Approximate annual gross production of the practice you would like to buy:
		$0-250,000 $250,000-500,000 $500,000-750,000 $750,000-1,000,000 over $1,000,000
	Do you have the ability of making a down payment on a practice?
		Yes No
	If Yes, how much do you have available?

	Do you need 100% financing?
		Yes No
	When would you like purchase a practice?
		Month Year
	Please comment on your areas of specialization in addition to general dentistry such as Oral Surgery, Periodontics, Endodontics, Cosmetics, Implants, TMJ, etc. (the purpose of this is that if you have specialty training or abilities in addition to general dentistry and a practice we have for sale does not offer these services this could be an advantage to you).

	Please give us any additional information that would be helpful in assisting us in matching you up with a practice:

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