To obtain a password - complete document, email or scan entire document to contact@samreader.com     

*MAKE SURE TO LIST E- MAIL SO WE CAN SEND YOU THE PASSWORD TO ACCESS THE CONFIDENTIAL PROFILE. PLEASE USE BLACK INK WHEN FILLING OUT THIS FORM .

CONFIDENTIALITY & AGENCY DISCLOSURE

1) AS A PROSPECTIVE BUYER I HEREBY CERTIFY THAT I AM NOT NOW NOR HAVE I EVER BEEN, AN EMPLOYEE OF THE INTERNAL REVENUE SERVICE OR ANY OTHER TAX COLLECTING AUTHORITY.

2) IF I AM A BROKER AND/OR THE AGENT, I AGREE THAT I HAVE BEEN RETAINED BY THE BUYER OF A CLINIC. I AM OBTAINING A PASSWORD AND/OR ADDITIONAL INFORMATION FOR THE SPECIFIC PURPOSE OF DUE-DILIGENCE ONLY.

3) I HEREBY AGREE TO KEEP TOTALLY CONFIDENTIAL ALL FACTS, FIGURES AND NAME(S) ASSOCIATED WITH ALL CLINICS LISTED WITH S.G.READER & ASSOCIATES, INC. 

4) I FURTHER AGREE NOT TO CONTACT THE DOCTOR/OWNER AND/OR STAFF OF SAID BUSINESS WITHOUT THE CONSENT OF S.G.READER & ASSOCIATES, INC. 

5) BUYER IS AWARE THAT THIS IS NOT A REAL ESTATE TRANSACTION.  IT IS THE SALE OF A BUSINESS.

6) SHOULD I DECIDE NOT TO PURCHASE THIS BUSINESS I WILL RETURN AND /OR DESTROY ALL INFORMATION GIVEN TO ME BY S.G. READER AND ASSOCIATES, INC.  AND /OR SELLER PERTAINING TO THE BUSINESS.

7) I HAVE BEEN TOLD THAT S.G. READER AND ASSOCIATES, INC.  WORKS FOR THE SELLER AND THAT I SHOULD SEEK LEGAL ADVICE PRIOR TO PROCEEDING WITH AN AGREEMENT OF SALE .

8) BUYER IS AWARE THAT THE SELLER HAS SUPPLIED THE INFORMATION TO S.G.READER & ASSOCIATES, INC. SHOWN ON THE CONFIDENTIALITY FORM AND /OR COMPLETE PRACTICE PROFILE AND ALL OTHER INFORMATION THAT WILL BE SUPPLIED FOR FURTHER DUE DILIGENCE BY THE BUYER.  BUYER IS AWARE THAT S.G.READER & ASSOCIATES, INC.  HAS NOT INVESTIGATED ANY OF THE FACTS PROVIDED BY THE SELLER.  S.G.READER & ASSOCIATES, INC.  SUGGEST BUYER RETAIN ATTORNEY, ACCOUNTANT OR ANY OTHER ADVISOR TO VERIFY ALL OF THE INFORMATION SUPPLIED BY THE SELLER.       

9) BUYER WILL HOLD S.G.READER & ASSOCIATES, INC.  HARMLESS PERTAINING TO ANY AND ALL CLINIC INFORMATION BEING PRESENTED, BE IT ACCURATE AND /OR INACCURATE.  BUYER AND /OR HIS/HER COUNSEL ASSUMES ALL RESPONSIBILITY.   

10) BUYER ACKNOWLEDGES READING , UNDERSTANDING AND RECEIVING A TRUE COPY OF THIS DOCUMENT  
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                                       PLEASE CHECK YOUR PROFESSION _______D.C.  _______P.T.  _______M.D.  ______D.D.S.   OTHER (SPECIFY)___________

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                                       PROSPECTIVE BUYER (PRINT NAME)
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                                      ADDRESS                                                                          CITY                               STATE                      ZIP CODE

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                                     *E- MAIL 
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                                      (MAKE CLEAR WE WILL EMAIL YOU PASSWORD!) 


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