Free 30 Minute Consultation

with Bentson Clark & Copple

Please fill out the form completely. When you are finished, click "Submit" and a Bentson Clark & Copple representative will contact you to schedule your personal consultation.

General Information

I am a:

Buyer Seller

I am interested in discussing:

Practice Valuation
Practice Transition - Purchase or sale of an Entire Practice
Practice Transition - Partnership
Practice Listing
Practice Opportunities
Desire to relocate
Uncertain and would like to discuss my options

Contact Information

First Name*:

Last Name*:

Address*:

City*:

State*:

Zip*:

Home Phone*:

Fax:

Cell Phone*:

Email*:

Best way to contact you*:

Practice Information (if applicable)

Years in practice:

This is a:

One Doctor Practice Multi-Doctor Practice

Transition timeframe:

Immediately

6-12 Months

1-2 Years

3-5 Years

Undecided

Number of offices:

Do you own your facility:

Yes No

Approximate gross collections:

Practice Website:

Anything else you would like us to know prior to our conversation:

Free 30 Minute Consultation

with Bentson Clark & Copple

General Information

Contact Information

Practice Information (if applicable)

For Sellers

For Buyers/Residents

800.621.4664