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Practice Valuation Details
Your first step is to send the following information to Dr. Fernandez so that he can determine a fair market value for the practice you are considering buying or selling. For your convenience, print this list by cutting and pasting into a Word document, or by downloading a PDF version by clicking here. (PLEASE NOTE: It is important to you that the information submitted be as accurate and complete as possible.)
Once Dr. Fernandez has received your information and completed his analysis (typically within 5 business days unless he is out of town), his assistant will call you to set up a time convenient for you and him to discuss the valuation. You will be sent (fax, mail or email - your choice) a copy of Dr. Fernandez' valuation report.
- Your name and daytime telephone number that you can be reached at.
- What is the physical address of the practice?
- Are you considering "buying" or "selling" the practice?
- Is the building for sale? If so, list the asking price and indicate if there is a mortgage/lien on the building, and if so, the amount.
- Is it mandatory for the person who buys the practice to also buy the building?
- List of all supplies and the value you place on them.
- List of all equipment, description, year, model #, etc., and the value you place on them. Are there any liens/leases, etc. on the equipment? If so, please indicate. (Please Note: Unless you provide an equipment appraisal, your practice valuation will include a "pending appraisal" notation next to the equipment value you supply.)
- Profit and loss statements for the last 2 years of the practice.
- Income tax returns for the last 2 years of the practice.
- Number of patient visits per month for the last 12 months.
- Number of new patients per month for the last 12 months.
- How old is the practice? How long has the selling doctor owned the practice?
- Why is the practice for sale?
Accounts Receivable detail:
| Cash: |
0 - 90 days |
$__________ |
90 - 120 days |
$___________ |
PI:
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| PI - Non LOP: |
0 - 90 days |
$__________ |
90 - 120 days |
$___________ |
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PI - LOP:
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0 - 90 days |
$__________ |
90 - 120 days |
$___________ |
| W/C: |
0 - 90 days |
$__________ |
90 - 120 days |
$___________ |
| MEDICARE: |
0 - 90 days |
$__________ |
90 - 120 days |
$___________ |
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(Within 12 visit parameters)
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| MEDICARE DENIED: |
0 - 90 days |
$__________ |
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| MAJOR MED: |
0 - 90 days |
$__________ |
90 - 120 days |
$__________ |
| MAJOR MED DENIED: |
0 - 90 days |
$__________ |
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And, any other information that you feel might be an important consideration.
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