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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.

  1. Your name and daytime telephone number that you can be reached at.
  2. What is the physical address of the practice?
  3. Are you considering "buying" or "selling" the practice?
  4. 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.
  5. Is it mandatory for the person who buys the practice to also buy the building?
  6. List of all supplies and the value you place on them.
  7. 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.)
  8. Profit and loss statements for the last 2 years of the practice.
  9. Income tax returns for the last 2 years of the practice.
  10. Number of patient visits per month for the last 12 months.
  11. Number of new patients per month for the last 12 months.
  12. How old is the practice?  How long has the selling doctor owned the practice?
  13. Why is the practice for sale?

Accounts Receivable detail:

Cash:  0 - 90 days $__________  90 - 120 days $___________
PI:  
       
     PI - Non LOP: 0 - 90 days $__________  90 - 120 days $___________

     PI - LOP:

0 - 90 days $__________ 90 - 120 days $___________
W/C: 0 - 90 days $__________  90 - 120 days $___________
MEDICARE: 0 - 90 days $__________  90 - 120 days $___________

(Within 12 visit parameters)

     
MEDICARE DENIED: 0 - 90 days $__________      
MAJOR MED: 0 - 90 days $__________ 90 - 120 days  $__________
MAJOR MED DENIED:  0 - 90 days $__________     


 

 

 

 

 

 

  

And, any other information that you feel might be an important consideration.

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