DENTAL PRACTICE WANTED

Associateship Wanted          Buy - In   Practice Purchase

Name:
Phone:

e-mail address
Fax:

Address:
City:
Postal Code:

TYPE OF PRACTICE:       
G.P. GENERAL (FAMILY)                    
SPECIALIST                  TYPE:

LOCATION (GENERAL):

^{1.     Lower Mainland                    2.     Vancouver
3.     Okanagan                             4.     Rural BC
5.     Vancouver Island                  6.     Victoria}

PRICE RANGE:        
ANNUAL GROSS REVENUE:

THE DATE BY WHICH YOU WOULD IDEALLY LIKE TO PURCHASE/ASSOCIATE:

NUMBER OF OPERATORIES:

YEAR GRADUATED:       
UNIVERSITY:

PROFESSIONAL PRACTICE EXPERIENCE:

(please list where you owned practices, had associateships, or salaried poitions and dates)

REFERRED TO AL HEAPS AND ASSOCIATES BY:

COMMENTS:

After completing this form, you must also complete a confidentiality agreement here and return it to us

To view practice purchase opportunities click here