Confidentiality Form

Potential Buyer's Confidentiality Agreement

All information contained in this form will be managed with strict confidentiality

As a Prospective Buyer, I wish to evaluate confidential information regarding practice opportunities presented by Arizona Transitions and Proactive Practice Management, referred to as broker.

• Prospective Buyer recognizes that any confidential information provide him/her by broker or its representative regarding professional practices could, if disclosed, cause damage to the individuals disclosing the information and to broker.
• Therefore, Prospective Buyer agrees that he/she will not divulge, communicate, or otherwise disclose any confidential material provided by broker, its representatives, or clients of broker, to anyone, including employees, customers, clients or prospective clients, with the exception of his/her spouse, accountant, and legal counsel.
• Prospective Buyer further agrees that his/her spouse, accountant, and legal counsel will maintain the confidentiality of the material as well.
• Confidential information shall include, but is not limited to, the following:

1. A professional intent to buy, sell, or associate.
2. Any financial data provided Prospective Buyer by broker, its representatives, or clients, which may included such items as value of practice under consideration, income statement or balance sheets, Internal Revenue Service returns, and any other personal financial data.
3. Any personal information provided Prospective Buyer by broker, its representatives, or clients, which may include such items as data regarding lawsuits, pending lawsuits, malpractice suits, or other items personally pertaining to the principals in these transactions.
4. Patient or client lists made known to Prospective Buyer during negotiations.

Prospective Buyer shall not contact any staff member of an owner referred to Prospective Buyer by broker without the express permission of the owner.

Prospective Buyer agrees to return any and all information provided to Prospective Buyer to broker immediately upon request.

In addition, Prospective Buyer acknowledges the following:

1. Broker is a transactional agent and does not have any fiduciary duties to Prospective Buyer.Information provided by broker is provided by the Seller and is not audited by broker.
2. Broker makes no claims as to the reliability of any such data.
3. It is Prospective Buyer ’s sole responsibility to conduct his/her own due diligence and confirm the accuracy of all information provided to Prospective Buyer by the owner and broker prior to any purchase.
4. Prospective Buyer indemnifies and holds broker harmless for any claim, loss or damages including expense of defense arising from any transaction agreed to by Prospective Buyer, including but not limited to court costs, reasonable attorneys’ fees and investigation expenses which, in any manner, arise out of or result from any practice purchase, employment, or affiliation;
5. Prospective Buyer is advised prior to any purchase, to review all financial and tax records of any practice, as well as personally perform a patient chart audit (subject to HIPAA regulations), determine patient count, review insurance plans, review HMO contracts, and any other information needed by Prospective Buyer;
6. Prospective Buyer acknowledges that broker is not an accounting firm and not a legal firm. Prospective Buyer has been advised to retain the services of competent and experienced legal counsel to review all agreements and other documents to be executed in connection with the sale/affiliation. Prospective Buyer’s legal counsel shall provide advice or opinion on the advisability of entering into a transaction.
7. Prospective Buyer has been advised to retain the services of an accountant to evaluate the data and the terms of the affiliation or sale including any tax liability resulting from such sale/affiliation.
8. Buyer agrees to include the following language in any formal agreement to purchase a practice (Similar language contained in the Consultant's Listing Agreement has been agreed to by the Seller): Seller and Purchaser together, individually and collectively, shall indemnify, defend and hold harmless Fred Heppner of Arizona Transitions ("Consultant") from and against any and all losses and expenses, including attorney's fees, of every kind and nature incurred by Consultant as a result of any disagreement or litigation solely or substantially between Seller and Purchaser occurring prior to, on or subsequent to the close of sale and related to said dental practice transaction. Seller and Purchaser have been encouraged by Consultant to seek out licensed professionals for legal, financial, and tax advice for their own protection. Seller and Purchaser agree that Consultant relies on information provided by each party without auditing its content or vouching for its accuracy; each party must complete their own due diligence.
9. All information provided to broker by Prospective Buyer is true and correct to the best of Prospective Buyer ’s knowledge, and may be presented to the owner of any practice under consideration for employment or acquisition by Prospective Buyer;
10. Upon completion of a transaction with Prospective buyer, broker shall be permitted to print, publish and mail its usual and customary professional announcement of the transaction;