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Tips on Selling Your Practice
Thank you for your interest in the U.S. HealthWorks clinic acquisition program.
Please complete the online form below and our Business Development department will contact you soon:
Practice Name:
Practice Address:
Practice Owner:
Name of Person completing this form
(Practice Representative):
Is the Pratice Owner a physician?
Yes
No
Composition of Practice
(check all that apply):
Urgent Care
Occupational Medicine
Family Practice / Primary Care
Physical Therapy
Other
Number of Office Locations:
Select a Number
1
2
3
4
5
6
7
8
9
10
More than 10
Approximate Annual Collections
(for last 12 months):
Select an amount
Less than $500,000
$500,001 to $1,000,000
$1,000,001 to $2,000,000
$2,000,001 to $4,000,000
Greater then $4,000,000
Email Address of Practice Owner or Representative:
Daytime phone of Practice Owner or Representative:
Preferred means of contact:
Phone
Email
Comments or Specific Instructions for U.S. HealthWorks Business Development Representative:
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