Detailed Buyer Survey Name* First Last Email* Mobile Phone*Preferred Method of Communication*EmailPhoneCurrent Zip Code* Year Graduated* Your Specialty*GeneralPediatricEndodontistOral SurgeonOrthodonticsImplantologyProsthodonticMulti-SpecialtyOtherDo you currently work as an associate?* Yes No Where are you looking for a practice?* Los Angeles Area Orange County Bay Area San Diego Inland Empire Central Coast Central Valley Sacramento Area Northern California Are there specific regions or cities you’re looking in?Ideal Practice Collections* $0 - $500,000 $500,000 - $1,000,000 $1,000,000 - $2,000,000 Over $2,000,000 Minimum Desired Take Home Income* $100,000 - $200,000 $200,000 - $300,000 $300,000 - $400,000 $400,000 - $500,000 Over $500,000 Would you like to own your building or suite?*I would like to purchase the real estate.I would like to lease my office space.I would be open to purchasing real estate.What insurance mix would be ideal in your new practice?PhoneThis field is for validation purposes and should be left unchanged.
